Weight-reduction and changes in renal function in CKD patients participating in a conservative multimodal obesity program.

Abstract

Due to the global epidemic of obesity, there is increasing interest in a distinct entity, called obesity-related nephropathy (ORN). Data on sustainable effects of weight reductions, with conservative, non-surgical treatment programs, on renal function in CKD patients are scarce. We retrospectively investigated patients with CKD (eGFR ≤ 60 mL/min/1.73m2) from a non-surgical multimodality obesity treatment program over 12 months. We identified 17 obese patients with CKD (estimated glomerular filtration rate (eGFR) ≤ 60 mL/min at baseline). 76% were female, 41% had type II diabetes mellitus, and the mean age was 59.6 ± 8.4 years (mean ± SD). Mean serum creatinine and eGFR at baseline were 106.4 ± 17.6 µmol/L and 53.4 ± 5.8 mL/min, respectively. Mean weight and body mass index (BMI) were 134.9 ± 26.4 and 50.1 ± 10.5 kg/m2, respectively. All subjects lost weight, with average weight loss of -32.2 ± 15.1 kg (p < 0.001) by the end of 12 months (BMI at 12 months 38.1 ± 7.8 kg/m2 (-12.0 ± 6.0 kg/m2, p < 0.001). Average 12-month creatinine was 92.2 ± 23.3 µmol/L, representing a drop of 14.2 ± 15.6 µmol/L (p = 0.004). Average eGFR increased by 14.8 ± 18.0 mL/min to a 12-month value of 68.2 ± 19.3 mL/min (p = 0.002). There were no significant differences when comparing patients with and without diabetes mellitus. These results demonstrate the potential renal impact of a non-surgical multimodal obesity program on renal function in very obese patients with CKD. Weight loss intervention should be highly encouraged especially in obese CKD patients.