Predicted Lean Body Mass and the Risk of Adverse Kidney Outcomes in Men

There are limited clinical data on whether low lean body mass is a risk factor for adverse kidney outcomes. We aimed to investigate the association between lean body mass, derived from a simple formula, and adverse kidney outcomes in men.

This cohort study utilized nationwide data from the DeSC database, encompassing a total of 468,597 men. The components for predicting lean body mass include age, height, body weight, waist circumference, and ethnicity. The primary outcome was a decrease in estimated glomerular filtration rate (eGFR) ≥ 40% from the baseline measurement.

During a mean follow-up of 4.0 years, a decrease in eGFR of ≥40% was observed in 2,047 individuals. Individuals in tertile 1 of predicted lean body mass had a higher risk of a decrease in eGFR of ≥40% than those in tertile 3 (hazard ratio, 1.54; 95% confidence interval, 1.33-1.78). In cubic spline analysis, the hazard ratio was observed to decrease progressively with higher predicted lean body mass up to the median level, after which it plateaued. The significant association between lower predicted lean body mass and the risk of eGFR of ≥40% was generally consistent across subgroups stratified by baseline characteristics, including eGFR levels.

Men with lower predicted lean body mass had a higher risk of adverse kidney outcome. Our results suggest the clinical importance of lean body mass assessment for kidney disease risk stratification.