Abstract MP16: Degree of Joint Risk Factor Control and Incident Chronic Kidney Disease Among Obese Individuals

Introduction: Individuals who are obese are at a higher risk for chronic kidney disease (CKD) than the non-obese population. Hypothesis: We assessed the hypothesis that controlling joint risk factors might reduce the increased risk of CKD observed in participants with obesity. Methods: We included a total of 97,538 participants who were obese at baseline and matched 97,538 normal weight control participants from the UK Biobank in the analysis. The degree of joint risk factor control was assessed based on 6 major CKD risk factors, including blood pressure, hemoglobin A1c, low-density lipoprotein cholesterol, albuminuria, smoking, and physical activity. The Cox proportional hazards models were used to estimate associations between the degree of risk factor control and risk of CKD. Results: Among obese participants, joint risk factor control showed an association with a stepwise reduction of incident CKD risk. Each additional risk factor control corresponded to an 11% (HR: 0.89, 95%CI: 0.86-0.91) reduced risk of CKD among obese participants; with the optimal controlling of all six risk factors associated with a 49% (HR: 0.51, 95% CI: 0.43-0.61) decrease in risk of CKD. Furthermore, in obese individuals who jointly controlled all six risk factors, the excess risk of CKD associated with obesity was effectively neutralized compared to normal weight control subjects. Notably, the protective correlations between the degree of joint risk factor control and the incidence of CKD were more pronounced in men compared to women, in individuals with a lower healthy food score versus a higher score, and among diabetes medication users as opposed to nonusers ( P for interaction=0.017, 0.033, 0.014 respectively). Conclusion: The joint risk factor control is associated with an inverse association of CKD risk in an accumulative manner among obese people. Achieving ideal control over risk factors may effectively counterbalance the excessive risk of CKD typically associated with obesity.