Higher BMI predicts major renal events in people with T2D

In a re-evaluation of ADVANCE (the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation) investigators wanted to find if there was a relationship between BMI and the risk of renal disease in people with type 2 diabetes. They used standardised methods to assess deterioration in renal disease, and followed up a cohort for 5 years. Every unit of BMI over 25 kg/m² increased the risk of major renal events by 4%. The analysts concluded that higher BMI, independent of medication use, is a predictor of major renal events in people living with type 2 diabetes.

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By Colin Kenny, Editor – Diabetes Distilled

There is some evidence of an association between obesity and renal disease. Analysts used the large cohort in ADVANCE to verify this, and to investigate potential mechanisms for any associations. Trial participants were stratified into six BMI categories from 18.5 to ≥40 kg/m². The composite outcome of major renal events was defined as development of new macroalbuminuria, doubling of creatinine, end-stage renal disease or renal death.

They found that during 5 years of follow-up, major renal events occurred in 487 (4.6%) participants. The risk increased with higher BMI. These findings were similar across subgroups by randomised interventions (intensive versus standard glucose control and perindopril/indapamide versus placebo). Every unit of BMI over 25 kg/m² increased the risk of major renal events by 4%.

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