Impact of metabolic phenotype changes on the development of chronic kidney disease: Panasonic cohort study 17

Abstract Objective This study investigated how changes in metabolic phenotype, defined by obesity and metabolic health, impact chronic kidney disease (CKD) development in a large cohort. Methods A retrospective cohort study analyzed health data collected between 2011 and 2021 from 84,729 Panasonic Holdings Corporation (formerly Panasonic Corporation) employees aged ≥40 years. Metabolic phenotypes were classified as metabolically healthy with no obesity (MHNO), metabolically healthy with obesity (MHO), metabolic abnormalities with no obesity (MANO), and metabolic abnormalities with obesity (MAO). Changes in metabolic phenotype over 3 years and their association with CKD development were assessed using Cox proportional hazards models adjusted for confounding variables. Results During a mean follow‐up of 5.1 years, a total of 12,172 of participants (14.4%) developed CKD. Transitioning from MHO to MHNO and from MAO to MANO did not reduce CKD risk compared to each stable group. In contrast, participants in the MANO‐to‐MHNO and MAO‐to‐MHO groups significantly lowered CKD risk relative to each stable group, with hazard ratios of 0.86 (95% CI: 0.77–0.96) and 0.83 (95% CI: 0.67–1.02), respectively. The same results were observed when a rapid decline in renal function was used as the outcome. Conclusions The improvement of metabolic profile might outweigh weight reduction in CKD risk.