Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial

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 (erMedD...

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Detalles Bibliográficos
Autores: Diaz-Lopez, A, Becerra-Tomas, N, Ruiz, V, Toledo, E, Babio, N, Corella, D, Fito, M, Romaguera, D, Vioque, J, Alonso-Gomez, AM, Warnberg, J, Martinez, JA, Serra-Majem, L, Estruch, R, Tinahones, FJ, Lapetra, J, Pinto, X, Tur, JA, Lopez-Miranda, J, Ibanez, NC, Delgado-Rodriguez, M, Matia-Martin, P, Daimiel, L, de Paz, JA, Vidal, J, Vazquez, C, Ruiz-Canela, M, Bullo, M, Sorli, JV, Goday, A, Fiol, M, Garcia-de-la-Hera, M, Sierra, LT, Perez-Farinos, N, Zulet, MA, Sanchez-Villegas, A, Sacanella, E, Fernandez-Garcia, JC, Santos-Lozano, JM, Gimenez-Gracia, M, Bibiloni, MD, Diez-Espino, J, Ortega-Azorin, C, Castaner, O, Morey, M, Torres-Collado, L, Sanchez, CS, Munoz, MA, Ros, E, Martinez-Gonzalez, MA, Salas-Salvado, J, PREDIMED-Plus Investigators
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p7027
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones7027
Access Level:acceso abierto
Palabra clave:Dietary intervention
Kidney function
Mediterranean diet
Weight loss
Glomerular filtration rate
PREDIMED-Plus
Descripción
Sumario: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 "PREvencion con DIeta MEDiterranea-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 m(2)) and micro- to macroalbuminuria (UACR >= 30 mg/g), and reversion of moderately (45 to <60 mL/min/1.73 m(2)) to mildly impaired GFR (60 to <90 mL/min/1.73 m(2)) or micro- to macroalbuminuria. Results: After 1 year, eGFR declined by 0.66 and 1.25 mL/min/1.73 m(2) in the intervention and control groups, respectively (mean difference, 0.58 mL/min/1.73 m(2); 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.

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