ACE and obesity due to melanocortin 4 receptor deficiency: Second, residual confounding might still be a limitation as we did not capture complete data on potential risk factors such as blood pressure, obesity, health behaviors (e.g., smoking status), or medications (e.g., use of angiotensin-converting enzyme inhibitors and/or angiotensin-receptor blockers), some of which have been associated with CKD outcomes23.