Health chats with Dr.Leeds | Overweight, obesity and Kidney disease | Dr Adrian Brown
In this conversation Dr Adrian Brown considers issues relating to the high prevalence of kidney disease globally, factors that increase risk for kidney disease and the extent to which improving risk factors may reduce kidney damage.
About 13% of the world’s population have chronic kidney disease (CKD), but in addition there may be many more who have the condition but are unaware of it. The risk of kidney disease increases with age, but also with high blood pressure and diabetes which can be effectively treated. High blood pressure and type 2 diabetes are also linked to overweight and obesity yet obesity is also an independent risk factor meaning that excess weight alone without high blood pressure and diabetes, increases risk.
Dr Brown discusses how weight reduction is not perhaps considered as an important therapeutic target in helping people with kidney disease partly due to a lack of clear evidence on how best to tackle weight reduction in the different stages of chronic kidney disease.
He draws attention to the fact that those with CKD and obesity who most need help are those with end-stage disease treated with haemodialysis, whose treatment with kidney transplantation is prevented by their obesity. He plans a clinical trial to determine whether or not weight loss with the type of dietary programme described in previous conversations in this series (weight loss initiated with an 800kcal/d soups and shakes diet followed by food reintroduction and effective weight maintenance – see episodes 1, 2 and 6) can enable people with end stage CKD and obesity to proceed to transplantation. This work will take 5 years or so to complete.
In the meantime, he gives guidance to those who may be concerned about their kidney function. He recommends using online risk calculators (see below) to determine risk, but also to ensure that blood pressure and type 2 diabetes are well controlled and to ensure that excess body weight is reduced. He recommends that those concerned should seek guidance from their medical practitioner or other health care provider and request the initial relatively easy tests of kidney function.
Weblinks to useful sources are given below.
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Kidney disease:
International Society of Nephrology: are your kidneys healthy?
Who is at risk for Kidney Disease.
Obesity, overweight and managing weight loss and maintenance:
What are the key principles of obesity management?
For Pakistan:
Obesity: how to prevent Pakistani people from becoming heavier?
High Blood pressre
Diabetes prevention:
The Canadian Diabetes Risk calculator:
The Indian Diabetes risk score:
UK Type 2 diabetes – know your risk
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