Published Online
on November 14, 2005

A more recent version of this article appeared on December 1, 2005

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Submitted on June 14, 2005
Revised on July 1, 2005

Body Mass Index and Angiotensin-Dependent Control of the Renal Circulation in Healthy Humans

Sofia B. Ahmed^*; Naomi D.L. Fisher; Radomir Stevanovic; and Norman K. Hollenberg

From the Departments of Medicine (S.B.A., N.D.L.F., R.S., N.K.H.) and Radiology (N.K.H.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.

^* To whom correspondence should be addressed. E-mail: sahmed7{at}partners.org.

Abstract--Obesity is increasingly recognized as a risk factor for renal disease, but the mechanism is unclear. Renal plasma flow response to captopril, as an index of renin-angiotensin system activity, was measured by para-aminohippurate clearance technique in 100 healthy, normotensive subjects in balance on a high-salt diet. Of the 100 subjects, body mass index exceeded 25 in 56 and exceeded 30 in 22. The average vasodilator response to captopril was 27±7 mL/min per 1.73 m² (P<0.0001). After adjustment for other predictors of the renal plasma flow response to captopril using a multivariate linear regression model, there was a highly significant relationship between age- and plasma renin activity-adjusted body mass index and the renal plasma flow response to captopril; however, a quadratic model provided a substantially better fit (r=0.55; P<0.0001; P=0.03 versus linear correlation). The strong association between increasing body mass index and angiotensin-dependent control of the renal circulation suggests that this may be a mechanism by which obesity contributes to renal disease. Weight loss should be considered in the overweight or obese patient for renal protection.

Key words: obesity • hemodynamics • body mass index • renin-angiotensin system • angiotensin II • kidney

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