The effects of weight change on glomerular filtration rate

Alex Chang, Tom H. Greene, Xuelei Wang, Cynthia Kendrick, Holly Kramer, Jackson Wright, Brad Astor, Tariq Shafi, Robert Toto, Julia Lewis, Lawrence J. Appel, Morgan Grams

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background. Little is known about the effect of weight loss/ gain on kidney function. Analyses are complicated by uncertainty about optimal body surface indexing strategies for measured glomerular filtration rate (mGFR). Methods. Using data from the African-American Study of Kidney Disease and Hypertension (AASK), we determined the association of change in weight with three different estimates of change in kidney function: (i) unindexed mGFR estimated by renal clearance of iodine-125-iothalamate, (ii) mGFR indexed to concurrently measured BSA and (iii) GFR estimated from serum creatinine (eGFR). All models were adjusted for baseline weight, time, randomization group and time-varying diuretic use. We also examined whether these relationships were consistent across a number of subgroups, including tertiles of baseline 24-h urine sodium excretion. Results. In 1094 participants followed over an average of 3.6 years, a 5-kg weight gain was associated with a 1.10 mL/min/1.73 m2 (95% CI: 0.87 to 1.33; P <0.001) increase in unindexed mGFR. There was no association between weight change and mGFR indexed for concurrent BSA (per 5 kg weight gain, 0.21; 95% CI: -0.02 to 0.44; P = 0.1) or between weight change and eGFR (-0.09; 95% CI: -0.32 to 0.14; P = 0.4). The effect of weight change on unindexed mGFR was less pronounced in individuals with higher baseline sodium excretion (P = 0.08 for interaction). Conclusion. The association between weight change and kidney function varies depending on the method of assessment. Future clinical trials should examine the effect of intentional weight change on measured GFR or filtration markers robust to changes in muscle mass.

Original languageEnglish (US)
Pages (from-to)1870-1877
Number of pages8
JournalNephrology Dialysis Transplantation
Volume30
Issue number11
DOIs
StatePublished - 2015

Keywords

  • Body surface area
  • Glomerular filtration rate
  • Indexing
  • Obesity
  • Weight

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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    Chang, A., Greene, T. H., Wang, X., Kendrick, C., Kramer, H., Wright, J., Astor, B., Shafi, T., Toto, R., Lewis, J., Appel, L. J., & Grams, M. (2015). The effects of weight change on glomerular filtration rate. Nephrology Dialysis Transplantation, 30(11), 1870-1877. https://doi.org/10.1093/ndt/gfv219