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."
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
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.
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.
Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, Minnesota, USA.
This article was published in the following journal.
Name: Current opinion in nephrology and hypertension
- 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).
General ill health, malnutrition, and weight loss, usually associated with chronic disease.
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.
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