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 Citations (Scopus)

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

Fingerprint

Glomerular Filtration Rate
Weights and Measures
Weight Gain
Kidney
Sodium
Iothalamic Acid
Kidney Diseases
Random Allocation
Diuretics
Iodine
African Americans
Uncertainty
Weight Loss
Creatinine
Clinical Trials
Urine
Hypertension
Muscles
Serum

Keywords

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

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Chang, A., Greene, T. H., Wang, X., Kendrick, C., Kramer, H., Wright, 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

The effects of weight change on glomerular filtration rate. / Chang, Alex; Greene, Tom H.; Wang, Xuelei; Kendrick, Cynthia; Kramer, Holly; Wright, Jackson; Astor, Brad; Shafi, Tariq; Toto, Robert; Lewis, Julia; Appel, Lawrence J.; Grams, Morgan.

In: Nephrology Dialysis Transplantation, Vol. 30, No. 11, 2015, p. 1870-1877.

Research output: Contribution to journalArticle

Chang, A, Greene, TH, Wang, X, Kendrick, C, Kramer, H, Wright, J, Astor, B, Shafi, T, Toto, R, Lewis, J, Appel, LJ & Grams, M 2015, 'The effects of weight change on glomerular filtration rate', Nephrology Dialysis Transplantation, vol. 30, no. 11, pp. 1870-1877. https://doi.org/10.1093/ndt/gfv219
Chang A, Greene TH, Wang X, Kendrick C, Kramer H, Wright J et al. The effects of weight change on glomerular filtration rate. Nephrology Dialysis Transplantation. 2015;30(11):1870-1877. https://doi.org/10.1093/ndt/gfv219
Chang, Alex ; Greene, Tom H. ; Wang, Xuelei ; Kendrick, Cynthia ; Kramer, Holly ; Wright, Jackson ; Astor, Brad ; Shafi, Tariq ; Toto, Robert ; Lewis, Julia ; Appel, Lawrence J. ; Grams, Morgan. / The effects of weight change on glomerular filtration rate. In: Nephrology Dialysis Transplantation. 2015 ; Vol. 30, No. 11. pp. 1870-1877.
@article{9c10333fa9e0476b96ff84220bb6083b,
title = "The effects of weight change on glomerular filtration rate",
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.",
keywords = "Body surface area, Glomerular filtration rate, Indexing, Obesity, Weight",
author = "Alex Chang and Greene, {Tom H.} and Xuelei Wang and Cynthia Kendrick and Holly Kramer and Jackson Wright and Brad Astor and Tariq Shafi and Robert Toto and Julia Lewis and Appel, {Lawrence J.} and Morgan Grams",
year = "2015",
doi = "10.1093/ndt/gfv219",
language = "English (US)",
volume = "30",
pages = "1870--1877",
journal = "Nephrology Dialysis Transplantation",
issn = "0931-0509",
publisher = "Oxford University Press",
number = "11",

}

TY - JOUR

T1 - The effects of weight change on glomerular filtration rate

AU - Chang, Alex

AU - Greene, Tom H.

AU - Wang, Xuelei

AU - Kendrick, Cynthia

AU - Kramer, Holly

AU - Wright, Jackson

AU - Astor, Brad

AU - Shafi, Tariq

AU - Toto, Robert

AU - Lewis, Julia

AU - Appel, Lawrence J.

AU - Grams, Morgan

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

KW - Body surface area

KW - Glomerular filtration rate

KW - Indexing

KW - Obesity

KW - Weight

UR - http://www.scopus.com/inward/record.url?scp=84948401334&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948401334&partnerID=8YFLogxK

U2 - 10.1093/ndt/gfv219

DO - 10.1093/ndt/gfv219

M3 - Article

C2 - 26085555

AN - SCOPUS:84948401334

VL - 30

SP - 1870

EP - 1877

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

SN - 0931-0509

IS - 11

ER -