Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 11-12, Pages: 772-779
https://doi.org/10.2298/SARH1112772L
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Prevalence of renal insufficiency in individuals with obesity
Ležaić Višnja (Medicinski fakultet, Beograd + Klinika za nefrologiju, Klinički centar Srbije, Beograd)
Zlatić Nataša (Medicinski fakultet, Beograd)
Zogović Jovana (Medicinski fakultet, Beograd)
Žarković Boris (Medicinski fakultet, Beograd)
Živković Bojana (Medicinski fakultet, Beograd)
Žakula Dejan (Medicinski fakultet, Beograd)
Živadinović Nenad (Medicinski fakultet, Beograd)
Zuković Milica (Medicinski fakultet, Beograd)
Vasiljević Nađa (Institut za higijenu i medicinsku ekologiju, Beograd)
Introduction. The association of obesity with renal function disorders has
been demonstrated by some studies. Objective. The aim of this study was to
assess the prevalence of renal insufficiency (RI), measured as glomerular
filtration rate (GFR) <60 ml/min and impact of weight loss on kidney
function in a cohort of 109 obese patients (body mass index - BMI >25
kg/m2), without previous kidney disease, and who underwent the dietician’s
treatment. Methods. According to body mass index (BMI), the patients were
classified as overweight (25-29.9 kg/m2, 25 patients), obesity grade I
(30-34.9 kg/m2, 37 patients), obesity grade II (35 to 39.9 kg/m2, 23
patients), and obesity grade III (>40 kg/m2, 24 patients). Data on
hypertension, cardiovascular diseases, diabetes, family illness history on
diabetes, obesity and hypertension, smoking and medications, lipid profile,
serum creatinine (sCr) measured before and after diet, and urine examination
were collected from the patients’ records. GFR was estimated using MDRD
formula (modification of diet in renal disease). Results The patients groups
were similar in age and co-morbidities, lipids, and sCr values. In
comparison to other obese patients, blood pressure was the highest in
obesity grade III patients (p=0.0001). Mean GFR rate before diet was
satisfactory in all studied groups. RI was present in 12.8% patients. After
diet nine patients still had GFR < 60ml/min, while lipids decreased in all
groups. Patients with the highest decrease of BMI also showed best
improvement in GFR. The risk for the development of decreased GFR was higher
in elderly patients (estimated rate: -0.434, p<0.0001). Conclusion. Obesity
is a potentially reversible risk factor for the development of decreased
GFR. The relationship between obesity and decreased GFR may be mediated by
the presence of known cardiovascular risk factors. In order to clarify the
obesity influence on renal functioning, further studies are needed.
Keywords: obesity, kidney function, prevalence of renal insufficiency, risk factors