The effect of body mass index (BMI) on the risk of developing end-stag
e renal disease (ESRD) has not been critically evaluated. To investiga
te this issue we used the registries of community-based mass screening
and chronic dialysis programs. In 1983, a total of 101,516 subjects (
47,901 men and 53,615 women) participated in a mass screening program
in Okinawa, Japan. A total of 187 (101 men and 86 women) entered an ES
RD program by March 31, 1994. Body mass index was calculated as weight
in kilograms divided by the square of the height in meters. Subjects
were categorized into six groups based on BMI: < 20.0, 20.0-21.9, 22.0
-23.9, 24.0-25.9, 26.0-27.9, and greater than or equal to 28.0 kg/m(2)
. The cumulative incidence of ESRD, per 100,000 subjects was calculate
d in each BMI subgroup for men and women. In men, the cumulative incid
ence of ESRD increased with BMI, except in the range of 24.0 to 25.9 k
g/m(2). In women, the association between the cumulative incidence of
ESRD and BMI was not clear, but was lowest in the range of 24.0 to 25.
9 kg.m(2). The adjusted odds ratio (95% confidence interval) was 0.99
(0.92 to 1.13) in men and 0.83 (0.72 to 0.96) in women.