Lifestyle intervention had little impact on eGFR slope in patients with type 2 diabetes
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Key takeaways:
- There were no significant differences in eGFR slope during 10 years between groups.
- Patients with baseline eGFR levels below 80 mL/min/1.73 m2 had a slightly higher longitudinal mean eGFR.
Intensive lifestyle intervention did not significantly change eGFR slope during 10 years in patients with type 2 diabetes and preserved kidney function, researchers found in a study.
“Obesity is a risk factor for type 2 diabetes and hypertension, the two leading causes of [chronic kidney disease] CKD,” Linda-Marie U. Lavenburg, DO, MSCE, of the renal-electrolyte division at the University of Pittsburgh School of Medicine, wrote with colleagues. But “limited data exist on longitudinal kidney outcomes after non-surgical obesity treatments,” they noted.
The post-hoc analysis evaluated 4,901 randomly selected adults, aged 45 to 75 years, with type 2 diabetes and a BMI of at least 25 kg/m2, who were enrolled in the Action for Health in Diabetes (Look AHEAD) study. Researchers conducted the controlled trial from 2001 to 2015 to evaluate 10-year effects of intensive lifestyle intervention on kidney outcomes.
Patients were in two groups: those on intensive lifestyle intervention and those receiving diabetes support and education as part of usual care. Overall, mean baseline eGFR was 89 mL/min/1.73 m2 and 83% of patients had a normal urine albumin-to-creatinine ratio (UACR). Primary outcome was eGFR slope, followed by mean eGFR and UACR.
Results showed no significant difference in eGFR slope during the course of 10 years between groups. Patients with baseline eGFR levels below 80 had a slightly higher longitudinal mean eGFR with lifestyle intervention compared to usual care. Baseline eGFR levels did not impact the effect of the intervention on eGFR slope or mean, according to the findings. Slope and mean UACR also did not vary significantly.
“Intensive lifestyle intervention is an individualized and effective approach to weight loss,” Lavenburg and colleagues wrote. “However, when studying the effects of weight loss interventions on kidney function, more rigorous measures of kidney function are needed to overcome the influence of dietary and body composition changes associated with weight loss approaches.”
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