Weight loss has an additive effect on the proteinuria reduction of angiotensin II receptor blockers in hypertensive patients with chronic kidney disease

Shin Young Ahn, Dong Ki Kim, Seung Seok Han, Jung Hwan Park, Sung Joon Shin, Sang Ho Lee, Bum Soon Choi, Chun Soo Lim, Suhnggwon Kim, Ho Jun Chin

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Weight reduction is a lifestyle intervention that has been introduced for prevention and management of chronic kidney disease (CKD). We investigate the additive anti-proteinuric effect of weight reduction on the usage of angiotensin II receptor blockers (ARBs) and its potential mechanisms in hypertensive CKD patients. Methods: This study is a subanalysis of data from an open-label, randomized, controlled clinical trial. Among the 235 participants, 227 were assigned to subgroups according to changes in body weight. Results: Fifty-eight participants (25.6%) were assigned to group 1 (≥ 1.5% decrease in body weight after 16 weeks), 32 participants (14.1%) were assigned to group 2 (1.5-0.1% decrease in body weight), and 136 participants (59.9%) were assigned to group 3 (≥ 0.0% increase in body weight). Characteristics at enrollment were not different among the three groups, but mean differences in weight and percent changes in urinary sodium excretion over the period were statistically different (P < 0.001 and P = 0.017). Over the study period, unintentional weight loss independently increased the probability of reduced albuminuria (group 1, relative risk 6.234, 95% confidence interval 1.913-20.315, P = 0.002). Among urinary cytokines, only podocalyxin level decreased significantly in participants who lost weight (P = 0.013). Conclusion: We observed that weight loss had an additive effect on the anti-proteinuric effects of ARBs in nondiabetic hypertensive CKD patients, although it was minimal. An additive effect was shown in both obese and non-obese participants, and its possible mechanism is related to reduction of podocyte damage.

Original languageEnglish
Pages (from-to)49-58
Number of pages10
JournalKidney Research and Clinical Practice
Volume37
Issue number1
DOIs
Publication statusPublished - 2018 Mar 1

Fingerprint

Angiotensin Receptor Antagonists
Chronic Renal Insufficiency
Proteinuria
Weight Loss
Body Weight
Weights and Measures
Podocytes
Body Weight Changes
Albuminuria
Life Style
Randomized Controlled Trials
Sodium
Confidence Intervals
Cytokines

Keywords

  • Angiotensin type II receptor blocker
  • Chronic renal insufficiency
  • Hypertension
  • Proteinuria
  • Weight loss

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

Weight loss has an additive effect on the proteinuria reduction of angiotensin II receptor blockers in hypertensive patients with chronic kidney disease. / Ahn, Shin Young; Kim, Dong Ki; Han, Seung Seok; Park, Jung Hwan; Shin, Sung Joon; Lee, Sang Ho; Choi, Bum Soon; Lim, Chun Soo; Kim, Suhnggwon; Chin, Ho Jun.

In: Kidney Research and Clinical Practice, Vol. 37, No. 1, 01.03.2018, p. 49-58.

Research output: Contribution to journalArticle

Ahn, Shin Young ; Kim, Dong Ki ; Han, Seung Seok ; Park, Jung Hwan ; Shin, Sung Joon ; Lee, Sang Ho ; Choi, Bum Soon ; Lim, Chun Soo ; Kim, Suhnggwon ; Chin, Ho Jun. / Weight loss has an additive effect on the proteinuria reduction of angiotensin II receptor blockers in hypertensive patients with chronic kidney disease. In: Kidney Research and Clinical Practice. 2018 ; Vol. 37, No. 1. pp. 49-58.
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AU - Kim, Dong Ki

AU - Han, Seung Seok

AU - Park, Jung Hwan

AU - Shin, Sung Joon

AU - Lee, Sang Ho

AU - Choi, Bum Soon

AU - Lim, Chun Soo

AU - Kim, Suhnggwon

AU - Chin, Ho Jun

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N2 - Background: Weight reduction is a lifestyle intervention that has been introduced for prevention and management of chronic kidney disease (CKD). We investigate the additive anti-proteinuric effect of weight reduction on the usage of angiotensin II receptor blockers (ARBs) and its potential mechanisms in hypertensive CKD patients. Methods: This study is a subanalysis of data from an open-label, randomized, controlled clinical trial. Among the 235 participants, 227 were assigned to subgroups according to changes in body weight. Results: Fifty-eight participants (25.6%) were assigned to group 1 (≥ 1.5% decrease in body weight after 16 weeks), 32 participants (14.1%) were assigned to group 2 (1.5-0.1% decrease in body weight), and 136 participants (59.9%) were assigned to group 3 (≥ 0.0% increase in body weight). Characteristics at enrollment were not different among the three groups, but mean differences in weight and percent changes in urinary sodium excretion over the period were statistically different (P < 0.001 and P = 0.017). Over the study period, unintentional weight loss independently increased the probability of reduced albuminuria (group 1, relative risk 6.234, 95% confidence interval 1.913-20.315, P = 0.002). Among urinary cytokines, only podocalyxin level decreased significantly in participants who lost weight (P = 0.013). Conclusion: We observed that weight loss had an additive effect on the anti-proteinuric effects of ARBs in nondiabetic hypertensive CKD patients, although it was minimal. An additive effect was shown in both obese and non-obese participants, and its possible mechanism is related to reduction of podocyte damage.

AB - Background: Weight reduction is a lifestyle intervention that has been introduced for prevention and management of chronic kidney disease (CKD). We investigate the additive anti-proteinuric effect of weight reduction on the usage of angiotensin II receptor blockers (ARBs) and its potential mechanisms in hypertensive CKD patients. Methods: This study is a subanalysis of data from an open-label, randomized, controlled clinical trial. Among the 235 participants, 227 were assigned to subgroups according to changes in body weight. Results: Fifty-eight participants (25.6%) were assigned to group 1 (≥ 1.5% decrease in body weight after 16 weeks), 32 participants (14.1%) were assigned to group 2 (1.5-0.1% decrease in body weight), and 136 participants (59.9%) were assigned to group 3 (≥ 0.0% increase in body weight). Characteristics at enrollment were not different among the three groups, but mean differences in weight and percent changes in urinary sodium excretion over the period were statistically different (P < 0.001 and P = 0.017). Over the study period, unintentional weight loss independently increased the probability of reduced albuminuria (group 1, relative risk 6.234, 95% confidence interval 1.913-20.315, P = 0.002). Among urinary cytokines, only podocalyxin level decreased significantly in participants who lost weight (P = 0.013). Conclusion: We observed that weight loss had an additive effect on the anti-proteinuric effects of ARBs in nondiabetic hypertensive CKD patients, although it was minimal. An additive effect was shown in both obese and non-obese participants, and its possible mechanism is related to reduction of podocyte damage.

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KW - Proteinuria

KW - Weight loss

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