Higher body mass index (BMI) is associated with a lower risk of end-stage renal disease (ESRD) among individuals without the metabolic syndrome, researchers reported online in Kidney International.

Bhupesh Panwar, MD, of the University of Alabama at Birmingham, and colleagues studied 21,840 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. ESRD developed in 247 of these participants over a mean follow-up of 6.3 years. 

Among subjects without metabolic syndrome, each 5 kg/m2 increment in BMI was associated a 30% decreased risk of ESRD. 

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Higher BMI was not associated with ESRD risk among participants with metabolic syndrome. Compared with normal-weight individuals (BMI 18.5–24.9 kg/m2) without metabolic syndrome, overweight individuals (BMI 25–29.9 kg/m2) and obese individuals (BMI of 30 kg/m2 or higher) with metabolic syndrome had a 2-fold increased risk of ESRD. 

Obese individuals without the metabolic syndrome had a 53% lower risk of ESRD.