THE IMPACT OF BODY WEIGHT MANAGEMENT IN CHRONIC KIDNEY DISEASE PATIENTS WITH OBESITY

Chronic kidney disease (CKD) and obesity are important public health concerns. We examined the influence of dietary management and physical exercises on renal function, lipid profiles and exercise tolerance of a group of CKD patients. We enrolled 45 obese patients with CKD from stage 1 to 3b with tailored by regular dietitian consultation, recommendations of adequate daily protein and caloric intake, and physical exercises for body weight (BW) reduction. The target was BW reduction ≥ 3%. Thirty eight obese CKD patients completed the study and 24 patients reached the target. Patients who reached the target was significant larger in total body fat decrement than those who failed (3.0% vs 0.5%, p = 0.003). In addition, total muscle mass, especially on trunk and lower limbs (1.2% vs 0%, P = 0.026) was significant decreased in patients who reached the target compared to those who failed. The laboratory data disclosed the significant reduction of Chol (0.7% vs. -19.3%; P = 0.007), LDL-C ( 3.7% vs. -37.6%; P < 0.001), and UA (0% vs. -0.8%; P = 0.025) between the two groups. The cardiorespiratory endurance to complete 800 meters run (375.1 ± 64.7 sec vs. 327.1 ± 84.0 sec; P = 0.001), abdominal muscle strength and endurance by times of sit-ups (13.6 ± 9.1 number/min vs. 19.9 ± 9.2; P = 0.005), and flexibility of the lower back by sit and reach (18.8 ± 10.8 cm vs. 27.8 ± 10.9 cm; P< 0.001) of the patients who reached the target were improved significantly after 2-months of physical exercise training and education.We conclude that combination of dietary management and exercises are effective in improving health-related physical fitness, blood pressure control, dyslipidemia and renal function in overweight or obese CKD patients. Supportive individualized programs for lifestyle change could exert beneficial effects. A longitudinal study with larger sample size is warranted to elucidate the efficacy of combination of dietary management and exercises