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Trim Your Waistline to Avoid Kidney Disease

Trim Your Waistline to Avoid Kidney Disease

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Obesity and albuminuria among adults with type 2 diabetes, by Holly Kramer and colleagues. Diabetes Care 32:851—853, 2009

What is the problem and what is known about it so far?
When we eat protein, resulting waste products are filtered out of our blood and into our urine by our kidneys. Over time, diabetes can damage kidneys, and useful protein can start leaking from the kidneys along with the waste products. The level of protein in our blood can tell us whether our kidneys are working properly. Having small amounts of protein in the urine is called microalbuminuria and is an early sign of kidney disease. Having larger amounts of protein in the urine is called macroalbuminuria and often leads to kidney failure. Even with improvements in blood pressure and blood glucose, about 2 percent of adults with type 2 diabetes get microalbuminuria each year. Efforts to treat and prevent microalbuminuria mostly involve taking medicines. But changing lifestyle behaviors, such as losing extra weight and exercising, is also important.

Why did the researchers do this particular study?
The researchers wanted to find out whether people with type 2 diabetes who are very overweight are more likely to get kidney disease.

Who was studied?
The study included nearly 5,000 people who were participating in the Look AHEAD (Action for Health in Diabetes) study that focused on lowering the risk of heart and blood vessel disease.

How was the study done?
At the start of the Look AHEAD study, participants had their waists and body mass index (BMI; a measure of overweight) measured and some also had tests of their total body fat. Patients provided urine samples to be tested for protein. Researchers performed statistical tests to see the effect of being overweight on the chance of getting albuminuria after taking other factors into consideration.

What did the researchers find?
People with the highest BMI and greatest waist measurements were more likely to have protein in their urine, but higher total body fat was not linked to urine protein levels.

What were the limitations of the study?
Only some of the participants in the study had their total body fat measured, which may have affected findings about the importance of this factor. Also, researchers did not have a direct way to measure fat levels around internal organs, which may have some bearing on the development of kidney disease.

What are the implications of the study?
When it comes to kidney disease, your total body fat is less important than whether you have excess fat around your waist (abdominal obesity). Overweight people with type 2 diabetes who have extra fat at their waist are more likely to get kidney disease. Weight loss may lower their risk, and both losing weight and taking appropriate medicines can slow or stop kidney disease that is caught early.
(from www.diabetes.org)