Effect of body weight on chronic kidney disease in patients with type II diabetes mellitus without proteinuria

The effect of body weight change on chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM) is unclear. In this nationwide, population-based cohort study, we investigated the association between body weight change and CKD in patients with T2DM using data from the Korean National Health Insurance Service (NHIS). Between January 2009 and December 2012, we analyzed data from 981,953 patients with T2DM without proteinuria who underwent two consecutive general health checkups. Body weight change was categorized as severe (≤-10%) and moderate (-10% to ≤-5%) weight loss, stable weight (-5% to ≤ 5%), and moderate (5% to ≤ 10%) and severe (> 10%) weight gain; during follow-up, the CKD incidence in these groups was 8.78%, 7.58%, 7.18%, 8.17%, and 9.26%, respectively. In a multivariate analysis using the stable weight group as reference, odds ratios (95% confidence interval) for CKD were 1.029 (0.986–1.085), 0.973 (0.951–0.996), 1.223 (1.118–1.260), and 1.462 (1.390–1.539) in the severe weight loss, moderate weight loss, moderate weight gain, and severe weight gain groups. Thus, weight gain > 5% significantly increased incident CKD risk in patients with T2DM without proteinuria, whereas moderate weight loss (5%–10%) was associated with reduced risk.