Mrs. Watcharasa Pitug

ID. 567110011-2

The Association between Waist Circumference and Renal Insufficiency

among Hypertensive Patients

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Contents

IntroductionObjectiveMethodsResultsConclusions

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Introduction

Chronic kidney disease (CKD) has become a global public health problem and is a common

condition in the United States(Alejandro et al.,2009 ; Essam et al.,2008 ; Adam

et al., 2007) In 2004, there were approximately 472,000

patients with treated ESRD (Alejandro et al.,2009 )

By 2030, expected to increase to more than 2 million. The estimated prevalence of earlier CKD stages (stages 1 through 4) in US adults was 24

to 28 million based on the 2000 (Adam et al., 2007)

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Chronic kidney disease: classification and clinical consequences

Relative risk of death in relation to kidney function(N=1,120,295 pts) CKD -KDOQI classification

Go AS et., 2004

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Modification of Diet in Renal Disease (MDRD) in Thailand

In 2007 : Chronic Renal Insufficiency patients 13.2% in state 3 and 0.61% in state 4

(Thawee Siriwong, 2007)

In 2008 : Chronic Renal Insufficiency patients in Thailand 17.5% (สมาคมโรคไตแห่�งประเทศไทย, 2008)

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Clinical complications of renal failure

Parathyroid gland

disturbances –renal bone

diseaseActive vitamin D deficiency

Atherosclerosis

and arterioscleros

isPolyneuropathy

No diuresis –overhydration

..and many others

Malnutrition/wasting

Immunodeficiency

Myocardial fibrosis and

cardiomyopathy

Loss of erythropoietin –

anaemia

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Gab of knowledge

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The relationship of obesity to Renal insufficiency is somewhat controversial.

While it is established that obesity increases the risk of hypertension, diabetes and dyslipidemia, it is not clear if excess abdominal waist circumference influences

Renal insufficiency independentlyCorrelation between waist circumference and (A) visceral

and (B) subcutaneous fat areas assessed by using computed tomography in 75 men (open circle; dotted lines) and 47

women (filled triangle; solid lines) with prevalent chronic kidney disease.

Fabiana et al.,2008

MethodsA analytic study was conducted all information were

collected from medical records of all patients diagnosed with Hypertension during 2012. The type of hypertension complications was based on Renal insufficiency was the main outcome of this study.

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ObjectiveTo investigate the association between abdominal waist

circumference and Renal insufficiency among hypertensive patients

The inclusion flow chart

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Exclude DM & DMHT(xx,xxx)

Exclude if not estimate waist circumference

(xx,xxx)

Results

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Basic characteristic of the individual included in the study

N=32,766

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Basic characteristic of the individual included in the study

N=22,167

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Table 2. Crude odds ratios of having Renal Insufficiency and their 95% confidence intervals for each factor

Waist CircumferenceP-value=0.877

(OR=0.99 ; 95%CI=0.85 to 1.14)

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Table. 3. Odds ratios (ORs) of having Renal Insufficiency and their 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)

Waist CircumferenceP-value=0.938 (Adjusted OR=1.01 ; 95%CI=0.82 to

1.24)

Conclusions

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