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Jwa-Kyung Kim,1 Young Rim Song,1 Young-Jun Kwon,2 Hyung Jik Kim,1 Sung Gyun Kim,1 Young-Su Ju21Department of Internal Medicine, Kidney Research Institute, 2Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang-si, South KoreaBackground: With increasing age, body fat increases and muscle mass reduces. Even people with a normal weight may have a higher percentage of body fat. The aim of this study is to investigate the association between increased body fat and renal function decline (RFD) in the general elderly population with normal or mildly impaired renal function.Method: We conducted a prospective study of 615 healthy individuals in the general Korean population aged ≥60 years who participated in two health screening check-ups separated by a 4-year period. Obesity was defined as the highest sex-specific tertiles of the percentage body fat (PBF). The main outcome was changes of estimated glomerular filtration rate (eGFR) during the 4 years. Significant RFD was defined as a decrease of eGFR over the upper quartile (≤-2.1% per year). Results: The mean age was 67.2±6.6 years. The median value of the absolute decline in the eGFR and the percent change was -3.0 mL/minute/1.73 m2 and -0.87%/year in men and -3.1 mL/minute/1.73 m2 and -0.89%/year in women, respectively. When stratified by sex-specific PBF tertiles, pronounced differences were observed in both sexes; those at the highest tertile of PBF showed the greatest decline in eGFR. Even after adjustments for traditional risk factors of RFD, PBF was independently associated with eGFR changes (ß=-0.181; P