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The Effects of Weight Loss on Renal Function in Patients with Severe Obesity
Abstract
Severe obesity is associated with increased renal plasma flow (RPF) and glomerular filtration rate (GFR). The aim of the present study was to examine whether weight loss may reverse glomerular dysfunction in obese subjects without overt renal disease. Renal glomerular function was studied in eight subjects with severe obesity (body mass index [BMI] 48.0 +/- 2.4) before and after weight loss. Nine healthy subjects served as controls. GFR and RPF were determined by measuring inulin and PAH clearance. In the obese group, GFR (145 +/- 14 ml/min) and RPF (803 +/- 39 ml/min) exceeded the control value by 61% (90 +/- 5 ml/min, P = 0.001) and 32% (610 +/- 41 ml/min, P < 0.005), respectively. Consequently, filtration fraction was increased. Mean arterial pressure, although normal, was higher than in the control group (101 +/- 4 versus 86 +/- 2 mmHg, P < 0.01). After weight loss, BMI decreased by 32 +/- 4%, to 32.1 +/- 1.5 (P = 0.001). GFR and RPF decreased to 110 +/- 7 ml/min (P = 0.01) and 698 +/- 42 ml/min (P < 0.02), respectively. Albumin excretion rate decreased from 16 microg/min (range, 4 to 152 microg/min) to 5 microg/min (range, 3 to 37 microg/min) (P < 0.01). Fractional clearance of albumin decreased from 3.2 x 10(-6) (range, 1.1 to 23 x 10(-6)) to 1.2 x 10(-6) (range, 0.5 to 6.8 x 10(-6)) (P < 0.02). This study shows that obesity-related glomerular hyperfiltration ameliorates after weight loss. The improvement in hyperfiltration may prevent the development of overt obesity-related glomerulopathy.
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Steinberg, H. O., Chaker, H., Leaming, R., Johnson, A., Brechtel, G., & Baron, A. D. (1996) · Journal of Clinical Investigation · doi:10.1172/jci118709 · Cited by 1,687
Louis K. Dahl Memorial Lecture. Renal and cardiovascular mechanisms of hypertension in obesity.
Hall, J. E. (1994) · Hypertension · doi:10.1161/01.hyp.23.3.381 · Cited by 204
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Hsu, C.-Y., McCulloch, C. E., Iribarren, C., Darbinian, J., & Go, A. S. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-1-200601030-00006 · Cited by 1,390
Glomerular hyperfiltration in diabetes: mechanisms, clinical significance, and treatment
Tonneijck, L., Muskiet, M. H. A., Smits, M. M., van Bommel, E. J., Heerspink, H. J. L., van Raalte, D. H., & Joles, J. A. (2017) · Journal of the American Society of Nephrology · doi:10.1681/asn.2016060666 · Cited by 887
Obesity, hypertension, and chronic kidney disease
Hall, J., Juncos, L., Wang, Z., Hall, M., do Carmo, J., & da Silva, A. (2014) · International Journal of Nephrology and Renovascular Disease · doi:10.2147/ijnrd.s39739 · Cited by 520
Obesity and hypertension: two epidemics or one?
Davy, K. P., & Hall, J. E. (2004) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00707.2003 · Cited by 280
Is obesity a major cause of chronic kidney disease?
Hall, J. E., Henegar, J. R., Dwyer, T. M., Liu, J., da Silva, A. A., Kuo, J. J., & Tallam, L. (2004) · Advances in Renal Replacement Therapy · doi:10.1053/j.arrt.2003.10.007 · Cited by 264
Metadata
- Authors
- Chagnac, A., Weinstein, T., Herman, M., Hirsh, J., Gafter, U., & Ori, Y.
- Venue
- Journal of the American Society of Nephrology
- Published
- 2003-06
- Volume
- 14
- Issue
- 6
- Pages
- 1480-1486
- ISSN
- 1046-6673 (ISSN-L)
- OpenAlex
- W2165557874
- Cited by
- 541
- References
- 2
- FWCI
- 10.88
- Type
- journal article
- Language
- en
- Open access
- closed
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- Chagnac, A., Weinstein, T., Herman, M., Hirsh, J., Gafter, U., & Ori, Y. (2003). The Effects of Weight Loss on Renal Function in Patients with Severe Obesity. Journal of the American Society of Nephrology. https://doi.org/10.1097/01.asn.0000068462.38661.89
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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