Weight Loss Aids in Curing Chronic Kidney Disease


Abdullah Salim

Lose the Weight, Keep the Kidney


Promising studies show that obese individuals with mild to moderate kidney disease may be able to stop the progression of the disease by losing weight, whether by diet and exercise or through surgery. These were the findings from ‘Weight loss interventions in chronic kidney disease: a systematic review and meta-analysis;’ Sankar Navaneethan, MD, et al.; ‘Clinical Journal of the American Society of Nephrology’; 2009. The authors of the study stressed that more research needs to be done to determine the long-term effects on obese patients that undergo gastric bypass surgery. The authors also stressed that weight loss was recommended only for obese patients with chronic kidney disease. But since obesity is on the rise worldwide, more and more individuals fall into this category. This study also is not intended for patients in the advanced stages of chronic kidney disease. The Mayo Clinic notes that many patients with chronic kidney disease, especially the elderly, may suddenly lose too much weight and have difficulty getting back to a healthy weight. Study Details The study authors looked at the data from 13 studies of obese patients with chronic kidney disease, with six studies focused upon weight loss attained the old-fashioned way (diet and exercise) and seven studies focused on obese patients that underwent gastric bypass surgery. The study found that patients that had surgery often witnessed their diseased kidney returned to a normal state. The kidney was able to filter urine significantly better than before the surgery. The study found health benefits were achieved both through diet and exercise as well as through surgery. Both groups of patients attained lower blood pressure. Both groups were able to better handle their type 2 diabetes. Both groups were able to significantly slow the progress of kidney disease. Diseased kidneys produce urine with a protein in it called proteinuria. Protein is needed for the body. A specific protein called albumin is a crucial nutrient for blood cells. Albumin should not be present in large amounts in the urine. Proteinuria has the appearance of foam, as opposed to normal urine. When a kidney dies, it must be immediately removed from the patient. If the patient only has one kidney to begin with, then death is certain, unless a donor kidney can be found in time. In America alone, 3,000 individuals die annually while waiting for a kidney transplant, according to the US Department of Health and Human Services. Transplants are not an option for many individuals with chronic kidney disease. Why This Study Matters Doctors would prefer that obese patients with chronic kidney disease lose weight through diet and exercise rather than through drastic surgical means. Any type of surgery is susceptible to complications, such as the risk of infection. Gastric bypass surgery is also very expensive. In America, where over 46 million individuals do not have health insurance, such surgery is out of the question for many patients. Even if the patient did have health insurance, the insurance company may decide that gastric bypass surgery is not essential to saving the patient’s life. Meta-studies such as this one may show American health insurance companies that in some cases, gastric bypass surgery may save the kidney and the life of a kidney disease patient. It also shows why the weight loss eases the strain on the heart that is unsuccessfully trying to pump blood to the diseased kidney. The more obese the patient, the harder the heart must work. When there is insufficient blood to nourish the kidney, the organ becomes diseased and begins to shut down. That said, even in countries where there is socialized medicine, the study still matters. Knowing that weight loss is the key to helping obese patients with chronic kidney disease, doctors and hospitals can assess whether a patient has the time lose weight through a diet and exercise program before the kidney fails. This can eliminate some patients as candidates for gastric bypass surgery, translating into savings for the national health programs of such countries. When Surgery is the Better Option Obese kidney disease patients with severe type 2 diabetes may benefit the most from gastric bypass surgery. In these patients, their diabetes has contributed to the kidney damage, along with decreased blood flow. Thus, these patients may not have the energy to exercise. Studies have also shown that obese patients may be cured of their type 2 diabetes through lap band surgery. The most remarkable was ‘Bariatric Surgery. A Systematic Review and Meta-analysis;’ Buchwald H, et al. JAMA: The Journal of the American Medical Association. 2004; 292:1724-1737. It looked at over 22,000 cases of obese patients with type 2 diabetes (but not necessarily kidney disease) that underwent gastric bypass surgery. 86% of patients showed marked improvement in their blood sugar levels and 76.8% of patients had their diabetes disappear altogether. There is much about gastric bypass surgery, type 2 diabetes and chronic kidney disease that is not well known. But one thing is clear many lives could be saved through access to the surgery. The surgery itself is not a magic bullet because the patient will then need to diet and exercise for the rest of his or her life to prevent regaining weight, becoming obese and diabetic once again. Chronic kidney disease is reversible in its early stages. The Mayo Clinic adds that even acute kidney failure can also be reversible if the patient is generally healthy and has a healthy heart. In Conclusion The best way to stop type 2 diabetes and chronic kidney disease is for individuals to avoid obesity in the first place. Diabetes should be a loud warning signal that the weight needs to be managed. But some individuals ignore losing weight even when diagnosed with type 2 diabetes. This is not just laziness. It may be that they are too ill to exercise. In this case, gastric bypass surgery may save their lives and their kidneys.

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Weight Loss Aids in Curing Chronic Kidney Disease