Weight Loss May Mean Better Kidneys in Obese Patients

Action Points

• Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

ORLANDO -- Morbidly obese individuals who lost weight on a 12-week regimen of restricted calories paired with an exercise plan appeared to have significant kidney function improvement, as measured by glomerular filtration rate (eGFR), researchers reported here.

The average weight of the participants in the study was 289 lbs at baseline ( baseline body mass index 52.67 kg/m²) and that was reduced to an average of 260 lbs (P<0.0001) at 12 weeks, said Tiffany Schwasinger-Schmidt, MD, PhD, of the University of Kansas Medical School-Wichita, and colleagues.

As weight decreased, the eGFR increased from about 47.41 mL/min to almost 55.17 mL/min, which was significant (P=0.0289), the group reported at the American Association of Clinical Endocrinologists annual meeting.

"The correlation between weight loss and improved renal function persists even after controlling for diabetes and hypertension," Schwasinger-Schmidt said at a poster presentation.

The researchers performed a retrospective study that included adult patients who voluntarily enrolled in a physician-directed, medically supervised, community-based weight management program from 2009 through 2014.

"Patients consumed at least 800 kilocalories per day, attended weekly behavioral education classes, and expended approximately 300 kilocalories per day in physical activity," the authors explained.

The program excluded pregnant women, substance abusers, patients with documented eating disorders or aberrant eating behaviors, active malignancies, patients with end-stage renal disease, and patients with other infections, she said.

The average age of the participants in the study was 62.58; 45 of the 71 patients were women; and 91.6% were Caucasians.

Following 12 weeks of therapy, "80% of the patients improved in kidney disease stage. About 19% of the patients experienced no change in kidney disease stage, and one person experienced progression of kidney disease," she said.

Others benefits to the intervention were that about 64% of the patients required fewer antihypertensive medications, and 83% of the patients reduced their diabetic medications, she said.

The patients also saw statistically significant reductions in the following over the course of treatment:

• HbA1c: 1.03% drop (P=0.0012)
• Systolic blood pressure: 8.53 mmHg drop (P=0.0002)
• Diastolic blood pressure: 4 mmHg drop (P=0.0253)
• LDL cholesterol: reduction of 15.20 mg/dl (P=0.0041)

The researchers reported no difference in outcomes between patients who were diagnosed with diabetes and those who did not have a diabetes diagnosis.

"When you lose weight, and lower HbA1c and lower blood pressure it will have a positive effect on renal function," said Mitchell Roslin, MD, of Lenox Hill Hospital in New York City.

"Also when you have intense exercise, you also will get a positive effect on kidney function," he told MedPage Today. "This study shows that when you actively treat patients who are morbidly obese, you can achieve weight loss,"

But Roslin, who was not involved in the study, cautioned that the weight loss seen in patients on restricted calorie intakes and physical activity may be transitory.

"When you have body mass index of 53 kg/m² as seen in this population, you have to consider that surgery may by the only permanent weight loss solution," he said. "Most of the people who lose weight in these programs tends to put the weight back on after the intervention is completed."

He said it would be instructive to determine if the patients in this study had maintained that weight loss 15 months down the road.

Schwasinger-Schmidt disclosed no relevant relationships with industry.

Roslin disclosed no relevant relationships with industry.

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Weight Loss May Mean Better Kidneys in Obese Patients