Last Updated on November 1, 2026 9:59 pm by INDIAN AWAAZ
Dr Sourabh Sharma and Dr Sanjay Kalra
Optimal control of six key modifiable risk factors reduced the risk of chronic kidney disease (CKD) in persons with obesity by almost half, according to a study published in the journal Diabetes, Obesity and Metabolism.1
Rui Tang, from the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans and colleagues conducted this study to explore how comprehensive management of multiple risk factors could reduce the elevated risk of chronic kidney disease (CKD) in individuals with obesity. They analysed control of risk factors in 97,538 participants with obesity at baseline and compared them with 97,538 age- and sex-matched, normal-weight control participants without CKD from the UK Biobank. Joint risk factor control was evaluated by assessing six major CKD risk factors: blood pressure, smoking status, glycated hemoglobin (A1c), low-density lipoprotein cholesterol (LDL-C), albuminuria, and levels of physical activity. The participants were followed until the endpoints of the study, which were occurrence of CKD, death or the end of the follow-up period.
Over a median follow-up period of nearly 11 years, there were 3954 cases of incident CKD among participants with obesity and 1498 in matched participants without obesity. Analysis of risk factor revealed that 2487 participants with obesity had two risk factors under joint control; 12,720 had three risk factors under control, 32,388 had four risk factors under control, 36,988 had five risk factors under control, and 15,381 six risk factors under combined control. Participants with ≤2 risk factors under control were taken as the reference group.
After controlling for confounding variables, the adjusted HR of controlling ≤2 risk factors in persons with obesity was 2.11; for 3 risk factors, the aHR was 1.28; for four, it was 1.23; for five it was 1.22 and for all six factors, it was 0.99.
In participants with obesity, joint risk factor control was associated with a gradual reduction in the risk of developing CKD. Optimal control of each additional risk factor resulted in an 11% reduction in the risk of CKD risk with HR of 0.89, while optimal control of all six major risk factors led to a 49% decrease in CKD risk (HR 0.51). Moreover, in individuals with obesity who achieved successful control of all six risk factors, the increased risk of CKD typically linked to obesity was effectively eliminated, making their risk comparable to that of normal-weight control participants.
The protective effect of the degree of joint risk factor control was more robust in men than in women, in individuals with a lower healthy food score versus those with a higher score, and among diabetes medication users compared to non-users.
This study has demonstrated an inverse association between collective control of all six risk factors and CKD risk in a cumulative manner among individuals with obesity. All these risk factors are modifiable. A joint management strategy targeted at attaining optimal control of these risk factors can significantly and effectively offset the heightened risk of CKD typically linked to obesity.
Reference
1. Tang R, et al. Degree of joint risk factor control and incident chronic kidney disease among individuals with obesity. Diabetes Obes Metab. 2024 Aug 20. doi: 10.1111/dom.15874.
