Compliance with a structured weight loss program is associated with reduced systolic blood pressure in obese patients with chronic kidney disease.
BACKGROUND
The effectiveness of lifestyle-based weight loss programs in obese patients with chronic disease has not been widely studied. This study examined the effectiveness of a weight management program (WMP), and sought to determine factors associated with successful weight loss in obese patients with chronic kidney disease (CKD).


METHODS
In this prospective cohort study, all patients with a body mass index (BMI) of >30 kg/m(2) referred to our clinic from January 2005 to December 2008 and who commenced a structured WMP of an energy-reduced renal diet, exercise, and pharmacotherapy were included in the analyses. Changes in body weight and associated variables up to 24 months were assessed with intention-to-treat mixed linear models and predictors of weight loss were identified with multiple linear regression.


RESULTS
One hundred and thirty-five patients (56% male), of mean age 52.2 years and BMI 36.4 kg/m(2) commenced the WMP. Significant weight loss was achieved for all patients at 6, 12, 18, and 24 months. Weight loss at 12 months was predicted by compliance and age, but not by baseline BMI, blood pressure (BP), stage of CKD or pharmacotherapy use. Greater compliance was associated with decreased systolic BP, with no change in mean antihypertensive medication dose.


CONCLUSIONS
Significant weight loss was achieved, demonstrating the effectiveness of the WMP, and compliance with a structured program improved weight loss and systolic BP.
Diabetes and Nutritional Sciences Division, King's College London, London, UK. helen.maclaughlin@nhs.net
Helen L
HL
MacLaughlin
Pantelis A
PA
Sarafidis
Sharlene A
SA
Greenwood
Katrina L
KL
Campbell
Wendy L
WL
Hall
Iain C
IC
Macdougall
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010349:Patient Compliance; D011446:Prospective Studies; D061217:Weight Reduction Programs