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Tytuł pozycji:

Effect of large weight reductions on measured and estimated kidney function

Tytuł :
Effect of large weight reductions on measured and estimated kidney function
Index Terms :
Absorptiometry, Photon
Adult
Body Composition
Body Surface Area
Chromium Radioisotopes
Creatinine/metabolism
Cystatin C/metabolism
Diabetes Mellitus, Type 2/complications
Edetic Acid
Female
Gastric Bypass
Glomerular Filtration Rate
Humans
Kidney Function Tests
Male
Middle Aged
Muscle, Skeletal/diagnostic imaging
Obesity, Morbid/complications
Prospective Studies
Weight Loss
dk/atira/pure/researchoutput/pubmedpublicationtype/D016428
Journal Article
dk/atira/pure/researchoutput/pubmedpublicationtype/D013485
Research Support, Non-U.S. Gov't
article
Wydawca :
2017-02-06
Dodane szczegóły :
von Scholten, Bernt Johan
Persson, Frederik
Svane, Maria S
Hansen, Tine W
Madsbad, Sten
Rossing, Peter
Typ dokumentu :
Zasób elektroniczny
Dostępność :
Open access content. Open access content
info:eu-repo/semantics/openAccess
Pozostałe numery :
DAV oai:pure.atira.dk:publications/50b426d7-dc5d-4bdc-be9d-37057b6d58f1
https://curis.ku.dk/portal/da/publications/effect-of-large-weight-reductions-on-measured-and-estimated-kidney-function(50b426d7-dc5d-4bdc-be9d-37057b6d58f1).html
https://doi.org/10.1186/s12882-017-0474-0
https://curis.ku.dk/ws/files/194907692/s12882_017_0474_0.pdf
1048267080
Źródło wspomagające :
UNIV OF COPENHAGEN
From OAIster®, provided by the OCLC Cooperative.
Numer akcesji :
edsoai.on1048267080
Zasób elektroniczny
BACKGROUND: When patients experience large weight loss, muscle mass may be affected followed by changes in plasma creatinine (pCr). The MDRD and CKD-EPI equations for estimated GFR (eGFR) include pCr. We hypothesised that a large weight loss reduces muscle mass and pCr causing increase in eGFR (creatinine-based equations), whereas measured GFR (mGFR) and cystatin C-based eGFR would be unaffected if adjusted for body surface area.METHODS: Prospective, intervention study including 19 patients. All attended a baseline visit before gastric bypass surgery followed by a visit six months post-surgery. mGFR was assessed during four hours plasma51Cr-EDTA clearance. GFR was estimated by four equations (MDRD, CKD-EPI-pCr, CKD-EPI-cysC and CKD-EPI-pCr-cysC). DXA-scans were performed at baseline and six months post-surgery to measure changes in lean limb mass, as a surrogate for muscle mass.RESULTS: Patients were (mean ± SD) 40.0 ± 9.3 years, 14 (74%) were female and 5 (26%) had type 2 diabetes, baseline weight was 128 ± 19 kg, body mass index 41 ± 6 kg/m2 and absolute mGFR 122 ± 24 ml/min. Six months post-surgery weight loss was 27 (95% CI: 23; 30) kg, mGFR decreased by 9 (-17; -2) from 122 ± 24 to 113 ± 21 ml/min (p = 0.024), but corrected for current body surface area (BSA) mGFR was unchanged by 2 (-5; 9) ml/min/1.73 m2(p = 0.52). CKD-EPI-pCr increased by 12 (6; 17) and MDRD by 13 (8; 18) (p < 0.001 for both), while CKD-EPI-cysC was unchanged by 2 (-8; 4) ml/min/1.73 m2(p = 0.51). Lean limb mass was reduced by 3.5 (-4.4;-2.6; p < 0.001) kg and change in lean limb mass correlated with change in plasma creatinine (R2 = 0.28, p = 0.032).CONCLUSIONS: Major weight reductions are associated with a reduction in absolute mGFR, which may reflect resolution of glomerular hyperfiltration, while mGFR adjusted for body surface area was unchanged. Estimates of GFR based on creatinine overestimate renal function likely due to changes in muscle mass, whereas cys

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