Obesity and the risk of cardiovascular and all-cause mortality in chronic kidney disease: a systematic review and meta-analysis

摘要: Background Obesity is a risk factor for cardiovascular disease and death in people without chronic kidney (CKD), but the effect of obesity with CKD uncertain. Methods Medline Embase (from inception to January 2015) were searched cohort studies measuring by body mass index (BMI), waist:hip ratio (WHR) and/or waist circumference (WC) all-cause mortality or events patients any stage CKD. Data summarized using random effects models. Meta-regression was conducted assess sources heterogeneity. Results Of 4065 potentially eligible citations, 165 ( n = 1 534 845 participants) analyzed. In that found nonlinear relationship, underweight (3-5) on hemodialysis experienced an increased compared those normal weight. transplant recipients, excess observed at levels morbid (>35 kg/m 2 ). relationship be linear, increase BMI associated 3 4% reduction hemodialysis, respectively {adjusted hazard [HR] 0.97 [95% confidence interval (CI) 0.96-0.98] adjusted HR 0.96 (95% CI 0.92-1.00)}. Stages 3-5, every there 1% [HR 0.99 0.0.97-1.00)]. There no apparent association between transplanted peritoneal dialysis. Sparse data WHR WC did not allow further analyses. Conclusions Being obese may protective predialysis populations, while being suggests risk, recipients.