Predictors of end-stage renal disease and body mass index in a screened cohort

The effect of body mass index (BMI) on the risk of developing end-stage renal disease (ESRD) has not been critically evaluated. To investigate this issue we used the registries of community-based mass screening and chronic dialysis programs. In 1983, a total of 101,516 subjects (47,901 men and 53,615 women) participated in a mass screening program in Okinawa, Japan. A total of 187 (101 men and 86 women) entered an ESRD program by March 31, 1994. Body mass index was calculated as weight in kilograms divided by the square of the height in meters. Subjects were categorized into six groups based on BMI: < 20.0, 20.0-21.9, 22.0-23.9, 24.0-25.9, 26.0-27.9, and > or = 28.0 kg/m2. The cumulative incidence of ESRD, per 100,000 subjects was calculated in each BMI subgroup for men and women. In men, the cumulative incidence of ESRD increased with BMI, except in the range of 24.0 to 25.9 kg/m2. In women, the association between the cumulative incidence of ESRD and BMI was not clear, but was lowest in the range of 24.0 to 25.9 kg/m2. The adjusted odds ratio (95% confidence interval) was 0.99 (0.92 to 1.13) in men and 0.83 (0.72 to 0.96) in women.