Bregenz, Innsbruck The database of the Working Group on Preventive and Social Medicine is still booming and is still good for attracting international attention. A current example is a long-term study on obesity and kidney failure, which included data from 100,269 people undergoing health checks in Vorarlberg between 1985 and 2005. The study appeared in the Journal of the American Society of Nephrology (JASN). It was performed by a team led by Josef Fritz from Med Uni Innsbruck and senior physician Emanuel Zitt from LKH Feldkirch. The aim was to assess the long-term risk of irreparable renal failure requiring dialysis. Overweight and obesity alone have been shown not to lead to dialysis. What is relevant is what the measurements of the glucose index of triglycerides – a new parameter for insulin resistance -, uric acid and blood pressure show.
The researchers compared the results of the first check-up, which was on average 23 years ago, with entries in the Austrian Dialysis and Transplant Registry at the IV University Clinic of Internal Medicine. Using a complex mediation analysis, Fritz calculated the overall effect of obesity and the effect of individual influencing factors on an impending need for dialysis. An elevated TyG index and high blood pressure each contribute about one-third to the risk of kidney failure due to overweight and obesity. Scientists were surprised that the increase in uric acid had an equally large influence of 30 percent because it was hardly taken into account in the specialist literature. Obesity alone and cholesterol have a relatively low risk potential of one and two percent, respectively.
Of the 100,269 study participants whose data were provided by Aks, 32.4% showed metabolic risks during the first health check and 463 people (0.5%) developed renal failure in the following years.
The good news: all risk factors can be changed with lifestyle changes or appropriate therapy. “A normal weight, normal blood pressure, and healthy metabolism are probably a great guarantee for life-long freedom from dialysis,” says Emanuel Zitt, summarizing the results. VN-MM
“All risk factors can be modified with lifestyle changes or appropriate therapy.”