Supplementary Material-01._Supplemental_Material_AJN_2020_10_56_23112020.docx (764.06 kB)
Supplementary Material for: Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial
dataset
posted on 2021-02-08, 10:47 authored by Díaz-López A., Becerra-Tomás N., Ruiz V., Toledo E., Babio N., Corella D., Fitó M., Romaguera D., Vioque J., Alonso-Gómez Á.M., Wärnberg J., Martínez J.A., Serra-Majem L., Estruch R., Tinahones F.J., Lapetra J., Pintó X., Tur J.A., López-Miranda J., CanoIbañez N., Delgado-Rodríguez M., Matía-Martín P., Daimiel L., dePaz J.A., Vidal J., Vázquez C., Ruiz-Canela M., Bulló M., Sorlí J.V., Goday A., Fiol M., García-de-la-Hera M., TojalSierra L., Pérez-Farinós N., Zulet M.Á., Sánchez-Villegas A., Sacanella E., Fernández-García J.C., Santos-Lozano J.M., Gimenez-Gracia M., delMarBibiloni M., Diez-Espino J., Ortega-Azorin C., Castañer O., Morey M., Torres-Collado L., SortoSanchez C., Muñoz M.Á., Ros E., Martinez-Gonzalez M.A., Salas-Salvadó J., the PREDIMED-Plus InvestigatorsIntroduction: Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. Methods: Randomized controlled “PREvención con DIeta MEDiterránea-Plus” (PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55–75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (eGFR). Secondary outcomes were changes in urine albumin-to-creatinine ratio (UACR), incidence of moderately/severely impaired eGFR (<60 mL/min/1.73 m2) and micro- to macroalbuminuria (UACR ≥30 mg/g), and reversion of moderately (45 to <60 mL/min/1.73 m2) to mildly impaired GFR (60 to <90 mL/min/1.73 m2) or micro- to macroalbuminuria. Results: After 1 year, eGFR declined by 0.66 and 1.25 mL/min/1.73 m2 in the intervention and control groups, respectively (mean difference, 0.58 mL/min/1.73 m2; 95% CI: 0.15–1.02). There were no between-group differences in mean UACR or micro- to macroalbuminuria changes. Moderately/severely impaired eGFR incidence and reversion of moderately to mildly impaired GFR were 40% lower (HR 0.60; 0.44–0.82) and 92% higher (HR 1.92; 1.35–2.73), respectively, in the intervention group. Conclusions: The PREDIMED-Plus lifestyle intervention approach may preserve renal function and delay CKD progression in overweight/obese adults.
