Next Article in Journal
Combination of β-glucan and Morus alba L. Leaf Extract Promotes Metabolic Benefits in Mice Fed a High-Fat Diet
Previous Article in Journal
Chemotherapy-Related Toxicity, Nutritional Status and Quality of Life in Precachectic Oncologic Patients with, or without, High Protein Nutritional Support. A Prospective, Randomized Study
Article Menu

Export Article

Open AccessCase Report
Nutrients 2017, 9(10), 1109; doi:10.3390/nu9101109

Weight Loss in Advanced Chronic Kidney Disease: Should We Consider Individualised, Qualitative, ad Libitum Diets? A Narrative Review and Case Study

1
Department of Clinical and Biological Sciences, University of Torino (TO), 10100 Torino, Italy
2
Bioimis Accademia Alimentare, Bassano del Grappa (VI), 36061 Vicenza, Italy
3
Nephrology, Chivasso Hospital (Torino), 10034 Turin, Italy
4
Néphrologie, Centre Hospitalier Le Mans, 72000 Le Mans, France
*
Author to whom correspondence should be addressed.
Received: 13 August 2017 / Revised: 22 September 2017 / Accepted: 6 October 2017 / Published: 11 October 2017
View Full-Text   |   Download PDF [242 KB, uploaded 18 October 2017]

Abstract

In advanced chronic kidney disease, obesity may bring a survival advantage, but many transplant centres demand weight loss before wait-listing for kidney graft. The case here described regards a 71-year-old man, with obesity-related glomerulopathy; referral data were: weight 110 kg, Body Mass Index (BMI) 37 kg/m2, serum creatinine (sCr) 5 mg/dL, estimated glomerular filtration rate (eGFR) 23 mL/min, blood urea nitrogen (BUN) 75 mg/dL, proteinuria 2.3 g/day. A moderately restricted, low-protein diet allowed reduction in BUN (45–55 mg/dL) and good metabolic and kidney function stability, with a weight increase of 6 kg. Therefore, he asked to be enrolled in a weight-loss program to be wait-listed (the two nearest transplant centres required a BMI below 30 or 35 kg/m2). Since previous low-calorie diets were not successful and he was against a surgical approach, we chose a qualitative, ad libitum coach-assisted diet, freely available in our unit. In the first phase, the diet is dissociated; he lost 16 kg in 2 months, without need for dialysis. In the second maintenance phase, in which foods are progressively combined, he lost 4 kg in 5 months, allowing wait-listing. Dialysis started one year later, and was followed by weight gain of about 5 kg. He resumed the maintenance diet, and his current body weight, 35 months after the start of the diet, is 94 kg, with a BMI of 31.7 kg/m2, without clinical or biochemical signs of malnutrition. This case suggests that our patients can benefit from the same options available to non-CKD (chronic kidney disease) individuals, provided that strict multidisciplinary surveillance is assured. View Full-Text
Keywords: chronic kidney disease; obesity; wait-listing for kidney transplantation; dialysis; weight loss; coach assisted diet; ad libitum diet chronic kidney disease; obesity; wait-listing for kidney transplantation; dialysis; weight loss; coach assisted diet; ad libitum diet
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Capizzi, I.; Teta, L.; Vigotti, F.N.; Tognarelli, G.; Consiglio, V.; Scognamiglio, S.; Piccoli, G.B. Weight Loss in Advanced Chronic Kidney Disease: Should We Consider Individualised, Qualitative, ad Libitum Diets? A Narrative Review and Case Study. Nutrients 2017, 9, 1109.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Nutrients EISSN 2072-6643 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top