Primary prevention of nephropathy in obese type 2 diabetic patient

• Authors: Plamen Yovchevski , Zhivka Boneva
• Languages of publication: EN

Abstracts

EN

We 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.

Keywords

EN

Diabetes mellitus type 2; Glomerular hyperfiltration; Diabetic nephropathy; Primary prevention

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2009
• Volume: 4
• Issue: 3
• Pages: 379-381

Dates

published

1 - 9 - 2009

online

3 - 7 - 2009

Contributors

author

Plamen Yovchevski

• Department of Nephrology, Medical Institute of Ministry of Interior, 1606, Sofia, Bulgaria

author

Zhivka Boneva

• Department of Endocrinology, Medical Institute of Ministry of Interior, 1606, Sofia, Bulgaria

References

• [1] 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
• [2] 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 [Crossref]
• [3] 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
• [4] Praga M., Obesity: A neglected culprit in renal disease, Nephrol. Dial. Transplant., 2002, 17, 1157–1159 http://dx.doi.org/10.1093/ndt/17.7.1157[Crossref]
• [5] Jandeleit-Dahm K., Cooper M.E., Hypertension and diabetes, Curr. Opin. Nephrol. Hypertens., 2002, 11, 221–228 http://dx.doi.org/10.1097/00041552-200203000-00014[Crossref]
• [6] Wolf G., After all those fat years: Renal consequences of obesity, Nephrol. Dial. Transplant., 2003, 18, 2471–2474 http://dx.doi.org/10.1093/ndt/gfg427[Crossref]
• [7] 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 http://dx.doi.org/10.1046/j.1523-1755.2001.0590041498.x[Crossref]
• [8] Mogensen C.E., Early glomerular hyperfiltration in insulin-dependent diabetics and late nephropathy, Scand. J. Clin. Lab. Invest., 1986, 46, 201–206 http://dx.doi.org/10.3109/00365518609083660[Crossref]
• [9] Griffin K.A., Kramer H., Bidani A.K., Adverse renal consequences of obesity, Am. J. Physiol. Renal. Physiol., 2008, 294, F685–F696 http://dx.doi.org/10.1152/ajprenal.00324.2007[Crossref]

Identifiers

DOI

10.2478/s11536-009-0043-4