Primary prevention of nephropathy in obese type 2 diabetic patient

Walter de Gruyter GmbH - 2009
П. Yovchevski1, Zhivka Boneva2
11Department of Nephrology, Medical Institute of Ministry of Interior, 1606, Sofia, Bulgaria
22Department of Endocrinology, Medical Institute of Ministry of Interior, 1606, Sofia, Bulgaria

Tóm tắt

AbstractWe report a case of a 36-year-old obese man who presented with newly onset diabetes mellitus type 2 and hypertension. The estimated value of glomerular filtration rate — 203.7 ml/min was associated with the patient being at high risk of developing progressive renal disease. In this case, in order to prevent nephropathy, the preferred therapy was a gradual bodyweight reduction. A low-calorie diet providing an 800 kcal/day deficit was recommended to the patient, as well as an increase in physical activity. After a total weight reduction of 50 kg (33% of initial bodyweight), the patient’s glomerular filtration, body mass index, and blood pressure normalized without any drug therapy. Glucose, blood pressure and lipid target levels can only be simultaneously achieved through body-weight reduction. In the presented case, we show the beneficial effects of bodyweight reduction, and dietary and physical activity changes on high glomerular filtration rate. Bodyweight reduction stops the cascade of events that are caused by glomerular hyperfiltration and the progression toward irreversible renal damage.

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Tài liệu tham khảo

ERA-EDTA Registry: ERA-EDTA Registry 2006 Annual Report. Academic Medical Center, Department of Medical Informatics, Amsterdam, The Netherlands, 2008, http://www.era-edta-reg.org/files/annualreports/pdf/AnnRep2006.pdf

Dengel D.R., Goldberg A.P., Mayuga R.S., Kairis G.M., Weir MR., Insulin resistance, elevated glomerular filtration fraction and renal injury, Hypertens., 1996, 28, 127–132

Chagnac A., Weinstein T., Korzets A., Ramadan E., Hirsch J., Gafter U., Glomerular hemodynamics in severe obesity, Am. J. Physiol. Renal. Physiol., 2000, 278, F817–F822

Praga M., Obesity: A neglected culprit in renal disease, Nephrol. Dial. Transplant., 2002, 17, 1157–1159

Jandeleit-Dahm K., Cooper M.E., Hypertension and diabetes, Curr. Opin. Nephrol. Hypertens., 2002, 11, 221–228

Wolf G., After all those fat years: Renal consequences of obesity, Nephrol. Dial. Transplant., 2003, 18, 2471–2474

Kambham N., Markowitz G.S., Valeri A.M., Lin J., D’Agati V.D., Obesity-related glomerulopathy: an emerging epidemic, Kidney Int., 2001, 59, 1498–1509

Mogensen C.E., Early glomerular hyperfiltration in insulin-dependent diabetics and late nephropathy, Scand. J. Clin. Lab. Invest., 1986, 46, 201–206

Griffin K.A., Kramer H., Bidani A.K., Adverse renal consequences of obesity, Am. J. Physiol. Renal. Physiol., 2008, 294, F685–F696

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Walter de Gruyter GmbH

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