Obesity and progression of chronic renal insufficiency: a Czech long term prospective double-blind randomised multicentre study


Authors: V. Teplan 1,2;  O. Schück 1,2;  V. Hanzal 1;  J. Hajný 3;  M. Horáčková 4;  M. Ryba 5;  I. Staněk 6;  S. Šurel 7;  M. Bret 8;  M. Štollová 1;  D. Sasaková 1
Authors‘ workplace: Klinika nefrologie, Transplantační centrum IKEM, přednosta prof. MUDr. Vladimír Teplan, DrSc. 1;  Subkatedra nefrologie IPVZ, Praha, vedoucí prof. MUDr. Vladimír Teplan, DrSc. 2;  HDS Chrudim, vedoucí lékař MUDr. Jan Hajný 3;  Interní klinika 2. lékařské fakulty UK a FN Motol, Praha, přednosta doc. MUDr. Milan Kvapil, CSc. 4;  Krajská nemocnice Liberec, Department č. l, vedoucí MUDr. Pavel Lang 5;  Interní oddělení Nemocnice, České Budějovice, přednosta prim. MUDr. Pavel Havránek 6;  Interní gastroenterologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Petr Dítě, DrSc. 7;  Interní oddělení NsP, Česká Lípa, přednosta prim. MUDr. Romana Balková 8
Published in: Vnitř Lék 2006; 52(6): 571-576
Category: Original Contributions

Práce byla přednesena na Českém nefrologickém kongresu v Luhačovicích ve dnech 17. - 19. 6. 2004 a na 12. mezinárodním kongresu Nutrice a metabolizmus u chorob ledvin konaném v Padově ve dnech 18. - 22. 6. 2004. V doplněné a rozšířené podobě pak na 27. Evropském kongresu pro parenterální a enterální výživu v Bruselu ve dnech 26. - 31. 8. 2005.

Overview

Obesity represents one of serious risk factors in chronic renal failure patients (CRF). In three years prospective double-blind randomised multicentre study we monitored 66 patients with advanced chronic renal insufficiency, GFR 24.4-37.3 ml/min (0.41-0.62 ml/s) and BMI ≥ 30 kg/m2 on long term low-protein diet (0.6 P/kg BW/day) and ACEi + ARB. Thirty four randomly selected patients (group I) were treated with keto amino acids, 32 patients in control group (group II) with placebo. During the study period significant decrease of BMI, proteinuria and slowing in progression of renal failure (Cin) were found. Significant changes were also noted in parameters of albumin and transferrin (p < 0.02), leucin and WQ (p < 0.01 - p < 0.02), glycaemia and HbA1c (p < 0.02), triglycerides (p < 0.01), leptin and ObRe (p < 0.01) and selected parameters of endothelial dysfunction (ET1, p < 0.02, TGFβ1, p < 0.02). Significantly also decreased PTH value (p < 0.01). Successful treatment of obesity can significantly improve long term prognosis in CRF patients.

Key words:
obesity - renal insufficiency - keto amino acids - progression


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Diabetology Endocrinology Internal medicine

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