Obesity Relation with Chronic Kidney Disease among Hypertensive Elderlies

Abstract

Introduction: Obesity and its intricate relationship with chronic conditions have been a subject of extensive research, with a particular focus on its association with chronic kidney disease among hypertensive elderly individuals. This systematic review aims to critically analyze existing literature, evaluate the strength of evidence for mitigating the impact of obesity on the development and progression of chronic kidney disease among hypertensive elderly individuals.

Methods: A systematic review was conducted by comprehensively searching PubMed, Embase, and Cochrane Library databases from January 2000 to August 2023 to identify studies investigating the association between obesity, hypertension, and chronic kidney disease (CKD) among hypertensive elderly individuals. The search utilized a combination of Medical Subject Headings (MeSH) terms and keywords specific to the relevant topics. Eligibility criteria were established, including a focus on hypertensive elderly individuals, observational or interventional study designs, and the provision of relevant outcome measures. The study selection process involved two independent reviewers screening titles and abstracts for relevance, followed by a detailed assessment of full texts based on predefined criteria. Studies meeting quality standards were included, while those with methodological limitations were considered in sensitivity analyses.

Results: Seven studies, incorporating diverse observational and interventional designs, contributed to a comprehensive understanding of the association between obesity, hypertension, and chronic kidney disease (CKD) among hypertensive elderly individuals. With sample sizes ranging from 213 to 1,569 participants across diverse geographic locations (North America, Europe, and Asia), the collective cohort of over 7,800 individuals enhanced the robustness and generalizability of the findings. The primary outcomes revealed statistically significant associations between obesity, hypertension, and CKD, emphasizing an elevated risk of CKD progression, with risk ratios ranging from 1.5 to 2.5. Longitudinal studies underscored the substantial impact of the coexistence of obesity and hypertension, with statistically significant decreases in estimated glomerular filtration rate (eGFR) averaging 10-15 mL/min/1.73m² over study periods. Additionally, interventions addressing obesity and hypertension demonstrated statistically significant improvements in kidney health outcomes.

Conclusions: The synthesis of findings from seven diverse studies underscores the compelling association between obesity, hypertension, and chronic kidney disease (CKD) among hypertensive elderly individuals. The elevated risk of CKD progression, consistently observed across varied study designs and geographical regions, highlights the urgent need for targeted interventions to mitigate the adverse impact of obesity on kidney health in this vulnerable population.