Table 1.

Characteristics of studies that analyzed the effects of dietary and pharmacologic interventions to reduce weight on renal parameters

ReferenceType of StudyBaseline Kidney DiseasePreintervention BMI (kg/m2)ComorbiditiesNo. of PatientsInterventionFollow-upRenal OutcomesNonrenal Outcomesa
Observational
    Cook et al. (24), 2008Prospective cohortStage 2 through 4 CKD and ESRD35.7 ± 4.5NA44 (total)
19 (predialysis)
22 (dialysis)
3 (transplant)
Hypocaloric (500 kcal less than usual), low-fat, renal diet plus exercise 3×/wk plus orlistat 120 mg thrice daily12 moeGFRExercise capacity, functional ability
    Saiki et al. (21), 2005Prospective cohortCreatinine <265 mmol/L and proteinuria >300 mg/d30.4 ± 5.3Diabetes22Hypocaloric diet (11 to 19 kcal/kg per d) using formula diet4 wk24-h creatinine clearance, 24-h proteinuriaLipid profile, HbA1c, visceral fat analysis using CT scan
    Solerte et al. (22), 1989Prospective cohortProteinuria >500 mg/d33.5 ± 1.6Diabetes, retinopathy24Hypocaloric diet (1410 kcal/d)12 moGFR (Tc injection), 24-h creatinine clearance, 24-h proteinuriaLipid profile, BP, HbA1c
    Vasquez et al. (25), 1984bProspective cohortProteinuria36.1; 47.6; 39.1Normal, borderline diabetes37Hypocaloric diet (500 kcal/d less than usual)82 to 110 dSerum creatinine, 24-h proteinuriaBP, albumin, liver function tests
Randomized
    Morales et al. (20), 2003Randomized studyProteinuric nephropathies with Cr <2.0 mg/dl33 ± 3.5Diabetes, hypertension30Hypocaloric diet (500 kcal less than usual); protein intake 1.0 to 1.2 g/kg per d versus usual dietary intake5 moCG creatinine clearance, 24-h proteinuriaLipid profile
    Praga et al. (23), 1995cRandomized studyProteinuria (>1 g/d) with Cr 0.8 to 2.3 mg/dl37.1 ± 3.1Hypertension17Hypocaloric diet (1000 to 1400 kcal/d) versus captopril 50 to 150 mg/d12 mo24-h creatinine clearance, 24-h proteinuriaLipid profile
  • CG, Cockcroft-Gault; Cr, creatinine; CT, computed tomography; eGFR, estimated GFR.

  • a All studies measured BMI and change in weight over time.

  • b Proteinuria data from these studies were not included in the analysis because of the lack of adequate information. This study had three arms: Normal control subjects, patients with borderline diabetes, and patients with type 2 diabetes.

  • c We used the pre- and postintervention data from the hypocaloric arm only for the analysis.