NIH National Library of Medicine published a study that examined the relationship between body mass index (BMI) and age at initiation of renal replacement therapy (RRT) in 3,556 patients with autosomal dominant polycystic kidney disease (ADPKD) from two national registries, the US Renal Data System (n=2,491) and the Japanese Society for Dialysis Therapy (n=1,065).

Patients in Japan initiated RRT at an older average age (61.6 vs. 56.6 years, P<.001) and had significantly lower BMI (22.0 vs. 28.2 kg/m², P<.001). Across both populations, lower BMI was independently associated with the delayed onset of end-stage kidney disease requiring RRT.

This inverse relationship held true after adjusting for confounding variables and within separate ethnic subgroups. Notably, Japanese participants were the leanest and oldest at RRT initiation, suggesting a slower disease trajectory.

Why is this important?

This study underscores the critical role of metabolic health in the progression of ADPKD. While genetic factors drive cyst formation, modifiable lifestyle factors like body weight, diet, and water intake may significantly impact disease progression. The finding that lower BMI correlates with later RRT initiation suggests that weight management could be a therapeutic target to delay kidney failure in ADPKD. Differences between US and Japanese cohorts also highlight the influence of national dietary patterns and lifestyle on kidney outcomes, reinforcing the value of cross-cultural research in chronic disease prevention.

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