The global challenge of weight-related issues in kidney disease

A new nationwide study from Japan spanning a 14 year study period has revealed an increasing trend of overweight and obesity in patients with the incident end-stage kidney disease (ESKD). Although, underweight individuals remain prevalent in this patient population, the study highlights that excessive weight and obesity in patients with the incident ESKD is a shared global challenge. Consequently, the study suggests the need for public health strategies to address the global obesity epidemic as well as underweight individuals in incident ESKD populations.

"The global prevalence of overweight and obesity has been rising steadily, this trend is apparent in the United States and Italy among patients with incident ESKD," said Dr. Wakasugi, the corresponding author of the study.

Japan is an exception to these trends; although the general male population demonstrates a similar increase, the prevalence of overweight and obesity have declined in young and elderly female populations. This raises a question as to whether the prevalence of overweight/obesity in the incident ESKD population also follows a similar pattern (i.e. an increasing trend in men but not in women), as in the case of the United States and Italy where the trend observed in the incident ESKD population mirrors that in the general population."

Minako Wakasugi, Niigata University

Using data from the Japanese Society of Dialysis Therapy Renal Data Registry and the National Health and Nutrition Survey from 2006 to 2019, this study observed a substantial increase in the age-adjusted prevalence of overweight and obesity among patients of the incident ESKD population for both sexes over the 14-year study period. Conversely, a similar increase in the general population was observed only for men. The prevalence rate of overweight and obese patients was higher in the incident ESKD population than in the general population across both sexes. Although the prevalence rate of underweight patients significantly decreased, still it was higher than that in the general population for both sexes throughout the study period.

"Our findings align with previous reports from the United States and Italy, suggesting that the burden of overweight and obesity in incident ESKD patients is a shared global challenge," said Dr. Wakasugi. "Our study also revealed that, though the prevalence of underweight patients significantly decreased in the incident ESKD population but was still much higher than that in the general population throughout the study period, indicating a dual challenge. Public health efforts should focus on mitigating the obesity epidemic whereas also addressing the prevalence of underweight individuals in the incident ESKD population."