Weight loss: a neglected intervention in the management of chronic kidney disease.
Summary of "Weight loss: a neglected intervention in the management of chronic kidney disease."
PURPOSE OF
REVIEW:
Obesity is being increasingly implicated as an independent risk factor for the development of chronic kidney disease (CKD), raising the question whether reversing obesity can be utilized as a mainstay or an adjunct therapy for CKD and possibly for its prevention. The purpose of this review is to examine the impact of treatment of obesity on renal outcomes. RECENT
FINDINGS:
Many observations have pointed to improvement in renal parameters following weight loss. In fact, both surgical and nonsurgical approaches appear to be effective at reducing blood pressure and proteinuria. Weight loss has also been shown to lower glomerular filtration rate (GFR) in obese patients, not an insignificant benefit considering that intra-glomerular hypertension and the subsequent hyperfiltration in the setting of obesity might be a main driver for the development of CKD.
SUMMARY:
Urinary protein excretion, blood pressure, and GFR improve with surgical and nonsurgical weight loss interventions. Whether improvements in these surrogate outcomes after weight loss actually translate into a reduction in the risk of CKD or amelioration in the rate of progression of established CKD is yet to be determined.
Affiliation
Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, Minnesota, USA.
Journal Details
This article was published in the following journal.
Name: Current opinion in nephrology and hypertension
ISSN: 1535-3842
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20827193
- DOI: http://dx.doi.org/10.1097/MNH.0b013e32833f13de
Medical and Biotech [MESH] Definitions
Renal Insufficiency, Chronic
Conditions in which the KIDNEYS perform below the normal level for more than three months. Chronic kidney insufficiency is classified by five stages according to the decline in GLOMERULAR FILTRATION RATE and the degree of kidney damage (as measured by the level of PROTEINURIA). The most severe form is the end-stage renal disease (CHRONIC KIDNEY FAILURE). (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002)
Kidney Failure, Chronic
The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.
Wasting Disease, Chronic
A transmissible spongiform encephalopathy (prion disease) of DEER and elk characterized by chronic weight loss leading to death. It is thought to spread by direct contact between animals or through environmental contamination with the prion protein (PRIONS).
Cachexia
General ill health, malnutrition, and weight loss, usually associated with chronic disease.
Hydronephrosis
Abnormal enlargement or swelling of a KIDNEY due to dilation of the KIDNEY CALICES and the KIDNEY PELVIS. It is often associated with obstruction of the URETER or chronic kidney diseases that prevents normal drainage of urine into the URINARY BLADDER.
PubMed Articles
Obesity and chronic kidney disease.
Obesity is associated with the early onset of glomerulomegaly, hemodynamic changes of a hyperfiltering kidney, and increased albuminuria, which are potentially reversible with weight loss. However, pa...
BackgroundThe effectiveness of lifestyle-based weight loss programs in obese patients with chronic disease has not been widely studied. This study examined the effectiveness of a weight management pro...
BACKGROUND: The prevalence of obesity in adults with intellectual disabilities (ID) is rising, although the evidence base for its treatment in this population group is minimal. Weight management inter...
The Effect of Weight Loss in Obesity and Chronic Kidney Disease.
Several epidemiologic investigations have confirmed that obesity is a significant risk factor for the appearance of proteinuria and end-stage kidney disease in a normal population. Weight loss induced...
Obesity increases the risk of progression of chronic kidney disease (CKD) towards kidney failure and may preclude access to kidney transplantation. Weight loss surgery remains relatively novel in obes...
Clinical Trials
Weight loss surgery is the most effective weight loss treatment available, but the direct effect on chronic kidney disease is less widely understood. Early research shows some improvement...
8-week Pilot Study of Relaxation for Weight Loss in Adults With Chronic Kidney Disease
Obesity plays a causal role for kidney disease incidence and progression. Moderate weight loss reduces the high metabolic demands on the kidney and decreases proteinuria in both diabetic...
There are few studies that look at sustained weight loss in the adolescent population. This study uses a multidisciplinary approach along with pharmacotherapy (use of Meridia)to motivate...
Trial of a Culturally-Appropriate Weight Loss Intervention for Overweight Latino Children
This project aims to conduct a unique, community-based intervention consisting of a randomized trial of a culturally-appropriate weight loss intervention for overweight Latino children in...
North Carolina WISEWOMAN: Weight-Wise Pilot Study
The purpose of this study is to test the effectiveness of a weight loss and weight loss maintenance intervention among low income women, conducted in a community health center setting.
