Chi-yuan Hsu, MD, MSc; Carlos Iribarren, MD, MPH, PhD; Alan S. Go, MD
Potential Financial Conflicts of Interest: None disclosed.
Hsu C., Iribarren C., Go A.; Body Mass Index and Risk for End-Stage Renal Disease. Ann Intern Med. 2006;144:701-702. doi: 10.7326/0003-4819-144-9-200605020-00022
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Published: Ann Intern Med. 2006;144(9):701-702.
We thank Drs. Thorp, Kalantar-Zadeh, and Kopple for their interest in our study, in which we showed that increased baseline BMI is a strong risk factor for ESRD. They questioned whether persons with CKD who are obese have paradoxically better survival than those who are not obese and whether what has been called “reverse epidemiology” could explain our findings.
We would like to emphasize that our study was not limited only to those persons with baseline CKD. Overall, 1036 out of 1471 cases of ESRD developed among individuals who did not have baseline CKD (defined as an estimated glomerular filtration rate of <60 mL/min per 1.73 m2, or proteinuria or hematuria by dipstick urinalysis). In the overall cohort, as expected, those with increased BMI had a higher risk for death from any cause (Table).
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