A large waist size increases the risk of death among patients with chronic kidney disease (CKD), data show.

In a study of 5,805 individuals aged 45 years and older and who had stage 1-4 CKD, men with a waist circumference of 122 cm or greater had a twofold increased risk of death compared with men who had a waist circumference less than 94 cm, after adjusting for covariates that included body mass index (BMI). Women with a waist size of 108 cm or greater were twice as likely to die than those with a waist circumference less than 80 cm, according to a report in the American Journal of Kidney Diseases (2011;58:177-185).

The study, led by Holly Kramer, MD, MPH, of Loyola University in Chicago, included patients enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. During a median follow-up of four years, 686 subjects (11.8%) died. Compared with subjects who had a BMI of 25-29.9 kg/m2 (reference group), those with a BMI less than 25 had a 27% increased risk of death, whereas patients with a BMI of 30-34.9, 35-39.9, and 40 or higher had a 16%, 19%, and 5% decreased risk, respectively, after adjusting for covariates that included waist circumference.

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“Waist circumference should be considered in conjunction with BMI when assessing mortality risk associated with obesity in adults with chronic kidney disease,” the authors concluded.