Fat and renal failure

SYDNEY, AUSTRALIA - FEBRUARY 04: Clients do floor exercises at the NuYu Weight Loss Retreat on February 4, 2010 in the Hawkesbury Valley near Sydney, Australia. Nuyu is a live-in style retreat offering programs that run for up to 6 weeks addressing all aspects of healthy living including exercise, meal planning, emotional well being and boast a 80% success rate for long term weight management. The latest statistics from the Dietitians Association of Australia state that 62% - more than 13 million Australian adults - and 25% of Australian children are overweight or obese. (Image credit: Getty Images via @daylife)

The relationship between kidney disease and obesity is explored by a systematic review of the available evidence by Sankar et al. The key take home points from the article are as follows.

• Obesity is important because nearly 2/3 of american adults are overweight and 50% of this number are obese. Thus giving rise to a very large prevalence. Any health conditions tied to obesity are therefore going to be equally prevalent.

• Obesity increases the incidence of known risk factors for kidney disease such as hypertension, diabetes and dyslipidemia.

• Obesity is a unique independent risk factor for kidney disease.

• Chronic kidney disease is increasing. Currently 20 million americans have CKD.

• The number of patients requiring dialysis will increase exponentially over time.

• The contribution of obesity to ESRD is likely to be very signficant directly and indirectly via diabetes and hypertension.

• The effects of weightloss on progression to ESRD is not clear.

The authors found that weight loss may offer benefits to patients with kidney disease. Weightloss resulted in decreased protein in the urine as well as stabilisation of a measure of kidney function the GFR. The benefits were more pronounced in patients who had bariatric surgery. The current evidence is pointing to a role of weightloss via surgical methods if necessary to slow the progression of CKD. To speak to this point more studies with longer follow up will  be needed.


photo credit: Tobyotter