The 10-Year Effects of Intensive Lifestyle Intervention on Kidney Outcomes

Limited data exist on longitudinal kidney outcomes after nonsurgical obesity treatments. We investigated the effects of intensive lifestyle intervention on kidney function over 10 years. Post hoc analysis of Action for Health in Diabetes (Look AHEAD) randomized controlled trial. We studied 4,901 ind...

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Bibliographic Details
Published in:Kidney medicine 2024-05, Vol.6 (5), p.100814-100814, Article 100814
Main Authors: Lavenburg, Linda-Marie U., Schaubel, Douglas E., Chao, Ariana M., Reese, Peter P., Cohen, Jordana B.
Format: Article
Language:English
Subjects:
Diabetes
kidney
lifestyle intervention
obesity
Original Research
weight loss
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Summary:Limited data exist on longitudinal kidney outcomes after nonsurgical obesity treatments. We investigated the effects of intensive lifestyle intervention on kidney function over 10 years. Post hoc analysis of Action for Health in Diabetes (Look AHEAD) randomized controlled trial. We studied 4,901 individuals with type 2 diabetes and body mass index of≥25kg/m2 enrolled in Look AHEAD (2001–2015). The original Look AHEAD trial excluded individuals with 4+urine dipstick protein, serum creatinine level of>1.4mg/dL (women), 1.5mg/dL (men), or dialysis dependence. Intensive lifestyle intervention versus diabetes support and education (ie, usual care). Primary outcome was estimated glomerular filtration rate (eGFR, mL/min/1.73m2) slope. Secondary outcomes were mean eGFR, slope, and mean urine albumin to creatinine ratio (UACR, mg/mg). Linear mixed-effects models with random slopes and intercepts to evaluate the association between randomization arms and within-individual repeated measures of eGFR and UACR. We tested for effect modification by baseline eGFR. At baseline, mean eGFR was 89, and 83% had a normal UACR. Over 10 years, there was no difference in eGFR slope (+0.064 per year; 95% CI: –0.036 to 0.16; P=0.21) between arms. Slope or mean UACR did not differ between arms. Baseline eGFR, categorized as eGFR of100, did not modify the intervention’s effect on eGFR slope or mean. Loss of muscle may confound creatinine-based eGFR. In patients with type 2 diabetes and preserved kidney function, intensive lifestyle intervention did not change eGFR slope over 10 years. Among participants with baseline eGFR
ISSN:2590-0595
2590-0595
DOI:10.1016/j.xkme.2024.100814