Acute caloric restriction improves glomerular filtration rate in patients with morbid obesity and type 2 diabetes.
OBJECTIVE
The role of caloric restriction in the improvement of renal function following bariatric surgery is still unclear; with some evidence showing that calorie restriction can reduce proteinuria. However, data on the impact of caloric restriction on renal function are still lacking.


METHODS
Renal function, as measured by glomerular filtration rate (GFR), was evaluated in 14 patients with type 2 diabetes mellitus, morbid obesity and stage 2 chronic kidney disease before and after a 7-day very low-calory diet (VLCD).


RESULTS
After the VLCD, both GFR and overall glucose disposal (M value) significantly increased from 72.6 ± 3.8 mL/min/1.73 m(-2) BSA to 86.9 ± 6.1 mL/min/1.73 m(-2) BSA (P=0.026) and from 979 ± 107 μmol/min(1)/m(2) BSA to 1205 ± 94 μmol/min(1)/m(2) BSA (P=0.008), respectively. A significant correlation was observed between the increase in GFR and the rise in M value (r=0.625, P=0.017).


CONCLUSIONS
Our observation of improved renal function following acute caloric restriction before weight loss became relevant suggesting that calory restriction per se is able to affect renal function.
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, Lungotevere de' Cenci 7, 00186 Rome, Italy.
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Giordani
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, Lungotevere de' Cenci 7, 00186 Rome, Italy.
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Malandrucco
Service of Medical Statistics & Information Technology, Fatebenefratelli Association for Research (SeSMIT-AFaR), S. Giovanni Calibita Fatebenefratelli Hospital, Lungotevere de' Cenci 5, 00186 Rome, Italy; AFaR, Unit of Internal Medicine, S. Giovanni Calibita Fatebenefratelli Hospital, Lungotevere de' Cenci 5, 00186 Rome, Italy.
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Donno
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, Lungotevere de' Cenci 7, 00186 Rome, Italy.
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Picconi
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, Lungotevere de' Cenci 7, 00186 Rome, Italy.
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Di Giacinto
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, Lungotevere de' Cenci 7, 00186 Rome, Italy.
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Di Flaviani
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, Lungotevere de' Cenci 7, 00186 Rome, Italy.
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Chioma
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, Lungotevere de' Cenci 7, 00186 Rome, Italy. Electronic address: frontoni@uniroma2.it.
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Frontoni
D001786:Blood Glucose / Q000378:metabolism*; D031204:Caloric Restriction / Q000379:methods; D003404:Creatinine; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000209:etiology / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism; D011507:Proteinuria; D016896:Treatment Outcome; D015431:Weight Loss
D001786:Blood Glucose; D007328:Insulin; D003404:Creatinine
Caloric restriction; Diabetes mellitus; Glomerular filtration rate; Morbid obesity