Being overweight or obese was associated with a greater risk for end-stage renal disease.

M e t h o d s Design: Cohort study. Setting: A health maintenance organization in northern California, United States. Patients: 320 252 adults who were ≥ 18 years of age (mean age 38 y, 54% women); participated in screening health checkups between 1964 and 1985; and had ≥ 1 concurrent measurement of height, weight, blood pressure, serum creatinine level, and dipstick urinalysis. Exclusion criterion was baseline serum creatinine level > 884 μmol/L (> 10 mg/dL). Risk factors: Being overweight (body mass index [BMI] 25 to 29.9 kg/m2), obese class I (BMI 30 to 34.9 kg/m2), obese class II (BMI 35 to 39.9 kg/m2), or obese class III (BMI ≥ 40 kg/m2). Results were adjusted for age, sex, race, educational level, smoking status, history of myocardial infarction, serum cholesterol level, urinalysis proteinuria, urinalysis hematuria, serum creatinine level, presence of diabetes, and baseline blood pressure. Outcomes: ESRD (receipt of renal transplantation, maintenance hemodialysis, or peritoneal dialysis). The ESRD data collection was blinded to risk factors.