Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Association between Obesity and Chronic Kidney Disease in Japanese: Differences in Gender and Hypertensive Status?


Obesity is a known risk factor for hypertension and diabetes, both of which ultimately promote renal dysfunction. In the current study, we investigated the association between body mass index (BMI) and chronic kidney disease (CKD) in 8,168 Japanese individuals (2,924 women, 5,244 men) who underwent general health screening. CKD was diagnosed if the estimated glomerular filtration rate (eGFR) was less than 60 mL/min/1.73 m2 (designated as low eGFR) and/or if the urinary albumin/creatinine value was equal to or greater than 30 mg/g (designated as albuminuria). Logistic regression analysis adjusted for age, systolic blood pressure, fasting glucose, and smoking habits showed that, in men, both overweight (BMI 25–29 kg/m2) and obesity (BMI ≥30 kg/m2) were associated with increased prevalence of low eGFR and albuminuria, whereas, in women, obesity was associated with albuminuria, but neither overweight nor obesity was associated with low eGFR. After multivariate adjustment, logistic regression analysis showed that BMI had a graded association with both low eGFR and albuminuria in men. On the other hand, in women, the second and third BMI quartiles were associated with a lower prevalence of albuminuria in comparison with the first BMI quartile. Essentially the same results were obtained when the subjects were subdivided according to the presence and absence of hypertension. Our data showed that overweight and obesity were associated with increased risk for CKD in Japanese individuals undergoing a general health screening, irrespective of the presence or absence of hypertension, although there was a gender difference in these associations.


  1. 1

    Flegal KM, Carroll MD, Ogden CL, Johnson CL : Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002; 288: 1723–1727.

    Article  Google Scholar 

  2. 2

    Gutierrez-Fisac JL, Banegas Banegas JR, Artalejo FR, Regidor E : Increasing prevalence of overweight and obesity among Spanish adults, 1987–1997. Int J Obes Relat Metab Disord 2000; 24: 1677–1682.

    CAS  Article  Google Scholar 

  3. 3

    Yoshiike N, Seino F, Tajima S, et al: Twenty-year changes in the prevalence of overweight in Japanese adults: the National Nutrition Survey 1976–95. Obes Rev 2002; 3: 183–190.

    CAS  Article  Google Scholar 

  4. 4

    Stengel B, Tarver-Carr ME, Powe NR, Eberhardt MS, Brancati FL : Lifestyle factors, obesity and the risk of chronic kidney disease. Epidemiology 2003; 14: 479–487.

    PubMed  Google Scholar 

  5. 5

    Hallan S, de Mutsert R, Carlsen S, Dekker FW, Aasarod K, Holmen J : Obesity, smoking, and physical inactivity as risk factors for CKD: are men more vulnerable? Am J Kidney Dis 2006; 47: 396–405.

    Article  Google Scholar 

  6. 6

    Hall JE, Kuo JJ, da Silva AA, de Paula RB, Liu J, Tallam L : Obesity-associated hypertension and kidney disease. Curr Opin Nephrol Hypertens 2003; 12: 195–200.

    CAS  Article  Google Scholar 

  7. 7

    Ravera M, Re M, Deferrari L, Vettoretti S, Deferrari G : Importance of blood pressure control in chronic kidney disease. J Am Soc Nephrol 2006; 17: S98–S103.

    Article  Google Scholar 

  8. 8

    Kramer H, Luke A, Bidani A, Cao G, Cooper R, McGee D : Obesity and prevalent and incident CKD: the Hypertension Detection and Follow-Up Program. Am J Kidney Dis 2005; 46: 587–594.

    Article  Google Scholar 

  9. 9

    Iseki K, Ikemiya Y, Kinjo K, Inoue T, Iseki C, Takishita S : Body mass index and the risk of development of end-stage renal disease in a screened cohort. Kidney Int 2004; 65: 1870–1876.

    Article  Google Scholar 

  10. 10

    Sakurai M, Miura K, Takamura T, et al: Gender differences in the association between anthropometric indices of obesity and blood pressure in Japanese. Hypertens Res 2006; 29: 75–80.

    Article  Google Scholar 

  11. 11

    Harada K, Karube Y, Saruhara H, Takeda K, Kuwajima I : Workplace hypertension is associated with obesity and family history of hypertension. Hypertens Res 2006; 29: 969–976.

    CAS  Article  Google Scholar 

  12. 12

    Manjunath G, Sarnak MJ, Levey AS : Prediction equations to estimate glomerular filtration rate: an update. Curr Opin Nephrol Hypertens 2001; 10: 785–792.

    CAS  Article  Google Scholar 

  13. 13

    Imai E, Horio M, Nitta K, et al: Estimation of glomerular filtration rate by the MDRD study equation modified for Japanese patients with chronic kidney disease. Clin Exp Nephrol 2007; 11: 41–50.

    Article  Google Scholar 

  14. 14

    Molitch ME, Rupp D, Carnethon M : Higher levels of HDL cholesterol are associated with a decreased likelihood of albuminuria in patients with long-standing type 1 diabetes. Diabetes Care 2006; 29: 78–82.

    CAS  Article  Google Scholar 

  15. 15

    K/DOQI clinical practice guidelines for chronic kidney disease : evaluation, classification, and stratification. Am J Kidney Dis 2002; 39: S1–S266.

  16. 16

    Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D : Predictors of new-onset kidney disease in a community-based population. JAMA 2004; 291: 844–850.

    CAS  Article  Google Scholar 

  17. 17

    Gelber RP, Kurth T, Kausz AT, et al: Association between body mass index and CKD in apparently healthy men. Am J Kidney Dis 2005; 46: 871–880.

    Article  Google Scholar 

  18. 18

    Orth SR, Stockmann A, Conradt C, et al: Smoking as a risk factor for end-stage renal failure in men with primary renal disease. Kidney Int 1998; 54: 926–931.

    CAS  Article  Google Scholar 

  19. 19

    Tozawa M, Iseki K, Iseki C, Oshiro S, Ikemiya Y, Takishita S : Influence of smoking and obesity on the development of proteinuria. Kidney Int 2002; 62: 956–962.

    Article  Google Scholar 

  20. 20

    Vupputuri S, Sandler DP : Lifestyle risk factors and chronic kidney disease. Ann Epidemiol 2003; 13: 712–720.

    Article  Google Scholar 

  21. 21

    Kurata A, Shigematsu Y, Higaki J : Sex-related differences in relations of uric acid to left ventricular hypertrophy and remodeling in Japanese hypertensive patients. Hypertens Res 2005; 28: 133–139.

    Article  Google Scholar 

  22. 22

    Shigematsu Y, Norimatsu S, Ohtsuka T, Okayama H, Higaki J : Sex-related differences in the relations of insulin resistance and obesity to left ventricular hypertrophy in Japanese hypertensive patients. Hypertens Res 2006; 29: 499–504.

    CAS  Article  Google Scholar 

  23. 23

    Paoletti E, Bellino D, Cassottana P, Rolla D, Cannella G : Left ventricular hypertrophy in nondiabetic predialysis CKD. Am J Kidney Dis 2005; 46: 320–327.

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Nobukazu Ishizaka.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ishizaka, N., Ishizaka, Y., Toda, Ei. et al. Association between Obesity and Chronic Kidney Disease in Japanese: Differences in Gender and Hypertensive Status?. Hypertens Res 30, 1059–1064 (2007).

Download citation


  • obesity
  • chronic kidney disease
  • gender difference
  • hypertension

Further reading


Quick links