Association between body roundness index and chronic kidney disease risk in patients with diabetes: A cross-sectional analysis of NHANES 1999-2018.

AIMS

To assess the association between Body Roundness Index (BRI) and chronic kidney disease (CKD) risk in individuals with diabetes.

METHODS

A cross-sectional analysis of 6,971 individuals with diabetes from NHANES 1999-2018 was conducted. BRI was calculated using waist circumference and height. CKD was defined as eGFR < 60 mL/min/1.73 m or ACR ≥ 30 mg/g. Weighted multivariable logistic regression assessed the BRI-CKD association. Subgroup and mediation analyses assessed heterogeneity and potential pathways.

RESULTS

Higher BRI was independently associated with increased CKD risk. In fully adjusted models, each unit increase in BRI corresponded to 10.5 % higher odds of CKD (OR: 1.109; 95 % CI: 1.040-1.183; p = 0.002). Stronger associations were found in males, younger individuals, and those with elevated blood pressure or uric acid. An inverse association was observed in participants with severe proteinuria. Mediation analysis showed partial effects through HbA1c (3.9 %), serum creatinine (27.7 %), and albumin (-26.2 %).

CONCLUSIONS

BRI is an independent marker of CKD risk in individuals with diabetes and may reflect contributions from glycaemic control, kidney function, and nutritional status. It may serve as a practical tool for CKD risk stratification.