Kidney Week

Abstract: FR-PO1171

Exploring the Effects of Low-Energy Diets on Risk Factors and Markers of Kidney Disease: Findings from the Slowing Kidney Disease with Weight-Loss Feasibility Study

Session Information

• CKD: Kidney Function and Extrarenal Complications
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Conley, Marguerite M., Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia

Marguerite M. Conley, RD, RDN

• Hepburn, Kirsten S., Kidney Health Service, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia

Kirsten S. Hepburn, MBBS, MPH

• Mayr, Hannah L., Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia

Hannah L. Mayr, PhD

• Mudge, David William, Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia

David William Mudge, MD, MBBS, FASN

• Holland, Justin James, Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia

Justin James Holland, PhD

• Viecelli, Andrea K., Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia

Andrea K. Viecelli, MD, PhD

• Johnson, David W., Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia

David W. Johnson, DrMed, MBBS, PhD, FASN

• MacLaughlin, Helen L., Dietetics & Food Services, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia

Helen L. MacLaughlin, PhD, RD

Background

Whether weight loss can delay or prevent the progression of obesity-associated CKD, and the amount of weight loss that may confer such benefit have not been well-established. This feasibility study explored kidney disease risk factors and markers of kidney function in a six-month randomised controlled trial (RCT).

Methods

Forty-nine adults with stages 1-3b CKD, body mass index (BMI) ≥30kg/m², and proteinuria (urinary protein to creatinine ratio (uPCR) >3mg/mmol) were randomised 1:1. The low energy diet (LED) group followed a 3-month LED (800-1000 kcal/day) with dietitian support; followed by a 3-month exercise and nutrition program. Usual care offered standard weight loss support. Changes in CKD risk factors and kidney markers were examined.

Results

Thirty-eight adults (78%) with a median age of 56 years, eGFR 57 mL/min/1.73m² and BMI 39kg/m² completed the study. At 6 months, significant intervention effects were observed for weight (WT) and waist circumference (WC) but not for uPCR, systolic blood pressure (SBP), diastolic blood pressure (DBP) or estimated glomerular filtration rate (eGFR) measures (Table 1). There was large variability across eGFR measures.

Conclusion

Low energy diets can significantly reduce body weight and waist circumference and may lead to improvements in eGFR, proteinuria and systolic blood pressure. Interpreting estimates of kidney function remains problematic when coupled with changes in body mass. Longer and larger trials exploring the use of LEDs on risk factors and measures of CKD progression are warranted.

Funding

• Private Foundation Support