Effects of weight loss on renal function in obese CKD patients: a systematic review - PubMed

Affiliations

• PMID: 24092846
• DOI: 10.1093/ndt/gft302

Review

Effects of weight loss on renal function in obese CKD patients: a systematic review

Davide Bolignano et al. Nephrol Dial Transplant. 2013 Nov.

Abstract

Obesity is an independent risk factor for the development and progression of chronic kidney disease (CKD). We conducted a systematic review to assess the benefits of intentional weight loss in obese subjects with altered glomerular filtration rate (GFR), proteinuria or albuminuria. MEDLINE, EMBASE and CENTRAL databases were searched for articles reporting longitudinal data on the effect of weight loss on renal parameters in obese patients with altered kidney function. Thirty-one (2013 subjects) were included. In the 13 studies where weight loss was achieved by bariatric surgery, body mass index (BMI) significantly decreased in all studies; GFR decreased in six studies on hyperfiltration patients and increased in one study on patients with CKD Stage 3-4. Albuminuria decreased in six studies and proteinuria decreased in five studies. In six studies, weight loss was achieved by antiobesity agents: BMI decreased in all studies; GFR decreased in four studies and albuminuria in three. Eleven studies analysed the effects of diet, alone or in combination with lifestyle modifications. A significant decrease in BMI was reported in all studies; GFR increased in two studies, remained stable in four studies and decreased in two studies on hyperfiltration patients. Albuminuria decreased in six studies and remained stable in one study. Proteinuria decreased in five studies. In obese patients with altered renal function, weight loss, particularly if achieved by surgical interventions, improves proteinuria, albuminuria and normalizes GFR. Larger, long-term studies are needed to analyse the durability of this improvement and the effects on renal outcomes, such as CKD progression and the development of ESKD.

Keywords: albuminuria; antiobesity agents; bariatric surgery; chronic kidney disease; diet; glomerular filtration rate; obesity; proteinuria; weight loss.

Similar articles

• Effects of Bariatric Surgery on Renal Function in Obese Patients: A Systematic Review and Meta Analysis.

  Li K, Zou J, Ye Z, Di J, Han X, Zhang H, Liu W, Ren Q, Zhang P. Li K, et al. PLoS One. 2016 Oct 4;11(10):e0163907. doi: 10.1371/journal.pone.0163907. eCollection 2016. PLoS One. 2016. PMID: 27701452 Free PMC article. Review.

• Effects of weight reduction regimens and bariatric surgery on chronic kidney disease in obese patients.

  Abou-Mrad RM, Abu-Alfa AK, Ziyadeh FN. Abou-Mrad RM, et al. Am J Physiol Renal Physiol. 2013 Sep 1;305(5):F613-7. doi: 10.1152/ajprenal.00173.2013. Epub 2013 Jul 3. Am J Physiol Renal Physiol. 2013. PMID: 23825072 Review.

• Weight loss interventions in chronic kidney disease: a systematic review and meta-analysis.

  Navaneethan SD, Yehnert H, Moustarah F, Schreiber MJ, Schauer PR, Beddhu S. Navaneethan SD, et al. Clin J Am Soc Nephrol. 2009 Oct;4(10):1565-74. doi: 10.2215/CJN.02250409. Epub 2009 Sep 17. Clin J Am Soc Nephrol. 2009. PMID: 19808241 Free PMC article. Review.

• Effect of drastic weight loss after bariatric surgery on renal parameters in extremely obese patients: long-term follow-up.

  Navarro-Díaz M, Serra A, Romero R, Bonet J, Bayés B, Homs M, Pérez N, Bonal J. Navarro-Díaz M, et al. J Am Soc Nephrol. 2006 Dec;17(12 Suppl 3):S213-7. doi: 10.1681/ASN.2006080917. J Am Soc Nephrol. 2006. PMID: 17130264

• Improved renal function 12 months after bariatric surgery.

  Hou CC, Shyu RS, Lee WJ, Ser KH, Lee YC, Chen SC. Hou CC, et al. Surg Obes Relat Dis. 2013 Mar-Apr;9(2):202-6. doi: 10.1016/j.soard.2012.10.005. Epub 2012 Oct 26. Surg Obes Relat Dis. 2013. PMID: 23246320

Cited by

• Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis.

  D'Agati VD, Chagnac A, de Vries AP, Levi M, Porrini E, Herman-Edelstein M, Praga M. D'Agati VD, et al. Nat Rev Nephrol. 2016 Aug;12(8):453-71. doi: 10.1038/nrneph.2016.75. Epub 2016 Jun 6. Nat Rev Nephrol. 2016. PMID: 27263398 Review.

• Association of age and BMI with kidney function and mortality: a cohort study.

  Lu JL, Molnar MZ, Naseer A, Mikkelsen MK, Kalantar-Zadeh K, Kovesdy CP. Lu JL, et al. Lancet Diabetes Endocrinol. 2015 Sep;3(9):704-14. doi: 10.1016/S2213-8587(15)00128-X. Epub 2015 Jul 30. Lancet Diabetes Endocrinol. 2015. PMID: 26235959 Free PMC article.

• Combined effect of body mass index and metabolic status on the risk of prevalent and incident chronic kidney disease: a systematic review and meta-analysis.

  Zhang J, Jiang H, Chen J. Zhang J, et al. Oncotarget. 2017 May 30;8(22):35619-35629. doi: 10.18632/oncotarget.10915. Oncotarget. 2017. PMID: 27579531 Free PMC article. Review.

• Effects of Bariatric Surgery on Renal Function in Obese Patients: A Systematic Review and Meta Analysis.

  Li K, Zou J, Ye Z, Di J, Han X, Zhang H, Liu W, Ren Q, Zhang P. Li K, et al. PLoS One. 2016 Oct 4;11(10):e0163907. doi: 10.1371/journal.pone.0163907. eCollection 2016. PLoS One. 2016. PMID: 27701452 Free PMC article. Review.

• Urinary fatty acid and retinol binding protein-4 predict CKD progression in severe NAFLD patients with hypertension: 4-year study with clinical and experimental approaches.

  Tsai YL, Liu CW, Huang SF, Yang YY, Lin MW, Huang CC, Li TH, Huang YH, Hou MC, Lin HC. Tsai YL, et al. Medicine (Baltimore). 2020 Jan;99(2):e18626. doi: 10.1097/MD.0000000000018626. Medicine (Baltimore). 2020. PMID: 31914044 Free PMC article.

Publication types

MeSH terms

LinkOut - more resources

• Full Text Sources

  • Ovid Technologies, Inc.
  • Silverchair Information Systems

• Other Literature Sources

  • scite Smart Citations

• Medical

  • MedlinePlus Consumer Health Information
  • MedlinePlus Health Information