Abstract
Objective: The association between body weight time in target range (TTR) and the risk of chronic kidney diseases (CKD) remains unknown. We aimed to assess the relationship of body weight TTR with incident CKD in people with overweight/obesity and type 2 diabetes mellitus (T2DM).
Methods: 3,601 participants with baseline estimated glomerular filtration rate (eGFR) ?60mL/min/1.73 m2 from the Look AHEAD (Action for Health in Diabetes) trial were included. Body weight TTR was defined as the proportion of time during the first 4 years that body weight was within the weight loss target (a weight loss of at least 7% from baseline). The primary outcome was incident CKD, defined as eGFR decline at least 30% from baseline and to a level of less than 60 mL/min/1.73 m2 at follow-up visit, or end-stage kidney disease.
Results: During a median follow-up duration of 8.0 years, 435 incident CKD were documented. Body weight TTR during the first 4 years was inversely associated with the subsequent risk of incident CKD (Per SD increment; adjusted HR:0.81, 95%CI: 0.70-0.93). Accordingly, the adjusted HRs (95% CI) of incident CKD were 1.00 (reference), 0.73 (0.54-1.00), 0.71 (0.52-0.99), and 0.54 (0.36-0.80) for participants with body weight TTR of 0%, 0%-<29.9%, 29.9%-<69.7%, and 69.7%-<100%, respectively. Similar results were found for incident albuminuria (secondary outcome).
Conclusions: A higher body weight TTR, with a weight loss target of losing at least 7% of initial weight, was associated with a lower risk of incident CKD in participants with overweight/obesity and type 2 diabetes.