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Effect of large weight reductions on measured and estimated kidney function
- Source :
- BMC Nephrology, von Scholten, B J, Persson, F, Svane, M S, Hansen, T W, Madsbad, S & Rossing, P 2017, ' Effect of large weight reductions on measured and estimated kidney function ', B M C Nephrology, vol. 18, 52 . https://doi.org/10.1186/s12882-017-0474-0
- Publication Year :
- 2016
-
Abstract
- BACKGROUND: When patients experience large weight loss, muscle mass may be affected followed by changes in plasma creatinine (pCr). The MDRD and CKD-EPI equations for estimated GFR (eGFR) include pCr. We hypothesised that a large weight loss reduces muscle mass and pCr causing increase in eGFR (creatinine-based equations), whereas measured GFR (mGFR) and cystatin C-based eGFR would be unaffected if adjusted for body surface area.METHODS: Prospective, intervention study including 19 patients. All attended a baseline visit before gastric bypass surgery followed by a visit six months post-surgery. mGFR was assessed during four hours plasma51Cr-EDTA clearance. GFR was estimated by four equations (MDRD, CKD-EPI-pCr, CKD-EPI-cysC and CKD-EPI-pCr-cysC). DXA-scans were performed at baseline and six months post-surgery to measure changes in lean limb mass, as a surrogate for muscle mass.RESULTS: Patients were (mean ± SD) 40.0 ± 9.3 years, 14 (74%) were female and 5 (26%) had type 2 diabetes, baseline weight was 128 ± 19 kg, body mass index 41 ± 6 kg/m2 and absolute mGFR 122 ± 24 ml/min. Six months post-surgery weight loss was 27 (95% CI: 23; 30) kg, mGFR decreased by 9 (-17; -2) from 122 ± 24 to 113 ± 21 ml/min (p = 0.024), but corrected for current body surface area (BSA) mGFR was unchanged by 2 (-5; 9) ml/min/1.73 m2(p = 0.52). CKD-EPI-pCr increased by 12 (6; 17) and MDRD by 13 (8; 18) (p CONCLUSIONS: Major weight reductions are associated with a reduction in absolute mGFR, which may reflect resolution of glomerular hyperfiltration, while mGFR adjusted for body surface area was unchanged. Estimates of GFR based on creatinine overestimate renal function likely due to changes in muscle mass, whereas cystatin C based estimates are unaffected.TRIAL REGISTRATION: ClinicalTrials.gov, NCT02138565 . Date of registration: March 24, 2014.
- Subjects :
- Male
Body Surface Area
Type 2 diabetes
medicine.disease_cause
urologic and male genital diseases
Kidney Function Tests
chemistry.chemical_compound
0302 clinical medicine
Absorptiometry, Photon
Weight loss
030212 general & internal medicine
Prospective Studies
Body surface area
Creatinine/metabolism
biology
Middle Aged
Obesity, Morbid
Nephrology
Cystatin C, DXA scan
Creatinine
Body Composition
Female
medicine.symptom
Glomerular filtration rate
Glomerular Filtration Rate
Research Article
Adult
medicine.medical_specialty
Muscle, Skeletal/diagnostic imaging
Urology
Gastric Bypass
Renal function
030209 endocrinology & metabolism
03 medical and health sciences
Internal medicine
Weight Loss
medicine
Humans
Cystatin C
Muscle, Skeletal
Edetic Acid
Bariatric surgery
business.industry
Gastric bypass surgery
Diabetes Mellitus, Type 2/complications
Muscle mass
medicine.disease
Chromium Radioisotopes
Obesity, Morbid/complications
Endocrinology
chemistry
Diabetes Mellitus, Type 2
biology.protein
Cystatin C/metabolism
business
Body mass index
Subjects
Details
- ISSN :
- 14712369 and 02138565
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC nephrology
- Accession number :
- edsair.doi.dedup.....bbd4c6b741344824b7d283234f66c188