Effect of subnormal estimated glomerular filtration rate on mortality varies by obesity metrics: a two-dimensional exposure–response analysis
Authors' conclusion
Subnormal eGFR was associated with elevated mortality in middle-aged and older adults, with risks more pronounced in those with greater central obesity. These findings underscore the importance of early intervention for subnormal eGFR and enhanced obesity management to improve resilience against kidney dysfunction in aging populations.
Study context
- Population
- Middle-aged and older adults with baseline subnormal estimated glomerular filtration rate (eGFR) (60–90 mL/min/1.73 m²) from the UK Biobankparticipants with baseline subnormal eGFR
- Participants
- 136,028 participants
- Comparison
- Changes in subnormal eGFR and mortality, and joint effects with obesity metrics (waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR))
- Outcome
- Deaths
- Follow-up
- Median 14.7 years (interquartile range: 13.8-15.4 years)
Methodological detailsFixed-effects Cox regression models, tensor product interaction functions
- Fixed-effects Cox regression models
- Tensor product interaction functions
Main finding
As reported in the abstract
Deaths occurred
12,396
Further findings
Mortality per 10-unit decrease in eGFR
- Excess mortality risk per 10-unit decrease in eGFR
- 9.1% (95% confidence interval 6.6%-11.7%)
- Fully-adjusted model
Heterogeneity across obesity metrics
- Substantial heterogeneity across obesity metrics, with stronger associations for higher levels of central obesity (WC and WHtR)
- Individuals with higher central obesity exhibited a forward shift in mortality risk thresholds, reflecting reduced adaptability to mild declines in eGFR
Age · baseline
- Mean age
- 59.5 ± 7.2 years
Original publication
Effect of subnormal estimated glomerular filtration rate on mortality varies by obesity metrics: a two-dimensional exposure–response analysis. Int J Obes (Lond). Published 11 November 2026. doi:10.
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