WWI is a robust predictor of cardiovascular and all-cause mortality in U.S. adults with CKD, with systemic inflammation partially mediating this relationship.
Higher WWI quartiles were associated with progressively increased odds of CVD prevalence in adults with CKD.
Higher WWI quartiles were associated with significantly increased risk of CVD-specific mortality in CKD patients.
Higher WWI quartiles were associated with significantly increased risk of all-cause mortality in CKD patients.
WWI demonstrated good discriminative ability for predicting CVD and all-cause mortality in CKD patients via ROC curve analysis.
Systemic inflammatory markers significantly mediated the associations between WWI and both all-cause and CVD-specific mortality.
The study utilized a prospective cohort design linking NHANES survey data to the National Death Index over a median follow-up of 79 months.
This research suggests that a relatively new body measurement called the Weight-adjusted Waist Index (WWI) — which accounts for belly fat relative to overall body weight — is a strong predictor of heart disease risk and death in people with chronic kidney disease (CKD). Using data from over 5,000 American adults tracked for a median of about six and a half years, the study found that people with CKD in the highest quarter of WWI scores were roughly 73% more likely to die from cardiovascular causes and 45% more likely to die from any cause compared to those with the lowest WWI scores. WWI also showed good accuracy in identifying who was at highest risk, with AUC values around 0.76–0.79, which are considered reasonably strong for a single measurement. The study also investigated why WWI might be linked to worse outcomes, finding that markers of body-wide inflammation — specifically the neutrophil-to-lymphocyte ratio and the systemic inflammation response index — partially explained the connection. This suggests that central (abdominal) fat may worsen outcomes in CKD patients at least partly by driving chronic inflammation, which in turn raises cardiovascular and mortality risk. However, since the mediation was only partial, other biological pathways likely also play a role. This research suggests that measuring WWI in CKD patients could help doctors better identify those at highest risk of heart disease and death, beyond what traditional obesity measures like BMI or waist circumference alone can capture. Incorporating WWI into routine CKD monitoring may help flag high-risk patients who might benefit from earlier or more aggressive intervention targeting abdominal adiposity and inflammation.
Wang Z, Li X, Zhu X, Hao Q, Kong F, Liu G. (2026). Weight-adjusted waist index and risk of cardiovascular and all-cause mortality in chronic kidney disease: NHANES 2005-2018 analysis of 5,381 adults.. Renal failure. https://doi.org/10.1080/0886022X.2026.2718572