Self-reported Intentional Weight Loss and Risk of Death in Moderate Chronic Kidney Disease in the United States

Abstract

Intentional weight loss in CKD participants was not associated with lower mortality risk. This might reflect residual confounding. Mechanistic and interventional studies are warranted to determine the effects of intentional weight loss in CKD.

Weight Loss Induced by Antiobesity Medications and All‐Cause Mortality Among Patients With Knee or Hip Osteoarthritis

“…Several studies have examined the relation of the rate of intentional weight loss through various interventions to death; the results, however, were inconsistent. 22,32 A post hoc analysis of the Look AHEAD study, an RCT conducted among adults with overweight or obesity and T2DM, showed that the fast rate of weight loss (ie, ≥10%) induced by intensive lifestyle intervention within one year had a lower risk of all-cause mortality than stable weight or weight gain (<2% loss); however, no such a difference was found between slow-to-moderate rate of weight loss (2%-10%) and stable weight or weight gain (<2% loss). 22 This study applied intensive lifestyle intervention to lose weight, which may be unlikely to result in long-term benefits in a real-world setting because of low adherence to the intervention.…”

“…This study applied intensive lifestyle intervention to lose weight, which may be unlikely to result in long‐term benefits in a real‐world setting because of low adherence to the intervention. Moreover, one cohort study conducted among patients with overweight or obesity and chronic kidney disease failed to show any association between one‐year intentional weight loss (either 5%–10% or ≥10%) induced by various interventions and all‐cause mortality 32 …”

Engaging Nutrition and Diet for Primary, Secondary, and Tertiary Prevention of Kidney Disease: The World Kidney Day 2020

“…In a historical cohort study from Japan by Hishida et al, 13 extended-hour hemodialysis treatment without dietary restrictions was associated with prevention of weight loss, especially in women and nondiabetic patients as well as those older than 65 years. Given that an unintentional weight loss in patients with CKD is associated with worse survival, 14 these data may have important clinical implications and strengthen the case for enforcing intradialytic nutrition including meals and supplements during hemodialysis. 15 Hung et al 16 suggested that lower bioelectrical impedance analysis calculated phase angle exhibit survival predictability in 760 incident peritoneal dialysis patients in China.…”

Chronic Kidney Disease and Obesity

“…In the study by Bansal et al [22], the association of self-reported intentional versus unintentional weight loss with all-cause mortality was examined. Unintentional weight loss of ≥10% was significantly associated with a higher risk of mortality; intentional weight loss was not associated with a lower mortality risk [22].…”

“…In the study by Bansal et al [22], the association of self-reported intentional versus unintentional weight loss with all-cause mortality was examined. Unintentional weight loss of ≥10% was significantly associated with a higher risk of mortality; intentional weight loss was not associated with a lower mortality risk [22]. It is important to highlight again that BMI is far from an ideal marker of obesity and patients with unintentional weight loss, malnutrition, and sarcopenia represent a different cohort of patients with different disease process (malignancy, uncontrolled systemic inflammation, etc.…”