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J Am Soc Nephrol 14:1480-1486, 2003
© 2003 American Society of Nephrology

The Effects of Weight Loss on Renal Function in Patients with Severe Obesity

Avry Chagnac, Tali Weinstein, Michal Herman, Judith Hirsh, Uzi Gafter and Yaacov Ori

Department of Nephrology, Rabin Medical Center-Golda Campus, Petah Tikva; Tel Aviv University Medical School, Tel Aviv, Israel.

Correspondence to Dr. Uzi Gafter, Nephrology Division, Rabin Medical Center, Golda Campus, 7 Keren Kayemet St., Petah Tikva 49372, Israel. Phone: 972-3-9372491; Fax: 972-3-9372311;

ABSTRACT. Severe obesity is associated with increased renal plasma flow (RPF) and glomerular filtration rate (GFR). The aim of the present study was to examine whether weight loss may reverse glomerular dysfunction in obese subjects without overt renal disease. Renal glomerular function was studied in eight subjects with severe obesity (body mass index [BMI] 48.0 ± 2.4) before and after weight loss. Nine healthy subjects served as controls. GFR and RPF were determined by measuring inulin and PAH clearance. In the obese group, GFR (145 ± 14 ml/min) and RPF (803 ± 39 ml/min) exceeded the control value by 61% (90 ± 5 ml/min, P = 0.001) and 32% (610 ± 41 ml/min, P < 0.005), respectively. Consequently, filtration fraction was increased. Mean arterial pressure, although normal, was higher than in the control group (101 ± 4 versus 86 ± 2 mmHg, P < 0.01). After weight loss, BMI decreased by 32 ± 4%, to 32.1 ± 1.5 (P = 0.001). GFR and RPF decreased to 110 ± 7 ml/min (P = 0.01) and 698 ± 42 ml/min (P < 0.02), respectively. Albumin excretion rate decreased from 16 µg/min (range, 4 to 152 µg/min) to 5 µg/min (range, 3 to 37 µg/min) (P < 0.01). Fractional clearance of albumin decreased from 3.2 x 10-6 (range, 1.1 to 23 x 10-6) to 1.2 x 10-6 (range, 0.5 to 6.8 x 10-6) (P < 0.02). This study shows that obesity-related glomerular hyperfiltration ameliorates after weight loss. The improvement in hyperfiltration may prevent the development of overt obesity-related glomerulopathy. E-mail: avryc@netvision.net.il




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