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RESEARCH PRODUCT
Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial
Miguel Angel MuñozJosé LapetraJordi Salas-salvadóNancy BabioMiquel FiolFrancisco J. TinahonesFrancisco J. TinahonesAndrés Díaz-lópezEmilio SacanellaEmilio SacanellaAlbert GodayNerea Becerra-tomásCarolina Ortega-azorínCarolina Ortega-azorínOlga CastañerNaomi Cano IbañezNaomi Cano IbañezJosep VidalJosep VidalCarolina Sorto SanchezJosé V. SorlíJosé V. SorlíJosé A. De PazJosé A. De PazPilar Matía-martínPilar Matía-martínMiquel Gimenez-graciaJulia WärnbergJulia WärnbergLaura Torres-colladoJosé Manuel Santos-lozanoJosep A. TurJosep A. TurLidia DaimielMaria Angeles ZuletMaria Angeles ZuletPredimed-plus InvestigatorsMaria Del Mar BibiloniMaria Del Mar BibiloniClotilde VázquezEstefanía ToledoEstefanía ToledoMònica BullóVerónica RuizMontse FitóJavier Díez-espinoJavier Díez-espinoManoli Garcia-de-la-heraJosé Carlos Fernández-garcíaJosé Carlos Fernández-garcíaDolores CorellaDolores CorellaRamon EstruchRamon EstruchÁNgel M. Alonso-gómezEmilio RosEmilio RosLucas Tojal SierraXavier PintóNapoleón Pérez-farinósNapoleón Pérez-farinósMarga MoreyMiguel ÁNgel Martínez-gonzálezMiguel ÁNgel Martínez-gonzálezMiguel ÁNgel Martínez-gonzálezJose Lopez-mirandaJose Lopez-mirandaMiguel Delgado-rodríguezMiguel Delgado-rodríguezMiguel Ruiz-canelaMiguel Ruiz-canelaJesús VioqueLuis Serra-majemLuis Serra-majemJ. Alfredo MartínezJ. Alfredo MartínezJ. Alfredo MartínezDora RomagueraAlmudena Sanchez VillegasAlmudena Sánchez-villegassubject
MaleWeight lossmedicine.medical_specialtyMediterranean diet*PREDIMED-PlusRenal functionUrineOverweightKidneyKidney Function Testsurologic and male genital diseases*Kidney function*Weight losslaw.invention*Mediterranean dietKidney functionRandomized controlled trialWeight losslawMediterranean dietInternal medicinemedicineHumans*Glomerular filtration rateObesity*Dietary interventionLife StyleAgedbusiness.industryIncidence (epidemiology)PREDIMED-PlusMiddle Agedmedicine.diseaseDietary interventionNephrologyFemaleGlomerular filtration ratemedicine.symptomMetabolic syndromebusinessdescription
Introduction: Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. Methods: Randomized controlled "PREvención con DIeta MEDiterránea-Plus"(PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55-75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (EGFR). Secondary outcomes were changes in urine albumin-to-creatinine ratio (UACR), incidence of moderately/severely impaired EGFR (<60 mL/min/1.73 m2) and micro-to macroalbuminuria (UACR ≥30 mg/g), and reversion of moderately (45 to <60 mL/min/1.73 m2) to mildly impaired GFR (60 to <90 mL/min/1.73 m2) or micro-to macroalbuminuria. Results: After 1 year, EGFR declined by 0.66 and 1.25 mL/min/1.73 m2 in the intervention and control groups, respectively (mean difference, 0.58 mL/min/1.73 m2; 95% CI: 0.15-1.02). There were no between-group differences in mean UACR or micro-to macroalbuminuria changes. Moderately/severely impaired EGFR incidence and reversion of moderately to mildly impaired GFR were 40% lower (HR 0.60; 0.44-0.82) and 92% higher (HR 1.92; 1.35-2.73), respectively, in the intervention group. Conclusions: The PREDIMED-Plus lifestyle intervention approach may preserve renal function and delay CKD progression in overweight/obese adults.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-01-01 | American Journal of Nephrology |