{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T02:06:52Z","timestamp":1777342012759,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Science &amp;amp; Practice"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Excess body weight is a risk factor for the progression of chronic kidney disease (CKD), but weight loss in CKD has been associated with higher mortality. Consequently, blanket weight loss recommendations in this population are controversial. Little data is available on the patterns of weight\u2010change in CKD. The authors aimed to describe weight\u2010changes in moderate\/severe CKD and explore associations with mortality and renal endpoints in patients with overweight and obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Non\u2010dialysis Canberra Hospital patients with estimated glomerular filtration (eGFR)\u00a0&lt;\u00a060\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup> and body mass index (BMI) \u226525\u00a0kg\/m<jats:sup>2<\/jats:sup> were followed for up to 5.5\u00a0years. Weight\u2010change \u22655% was considered clinically significant. The renal endpoint was defined as the commencement of dialysis or transplant or a \u226540% fall in eGFR. Relationships between weight\u2010change in the first year of follow\u2010up and mortality or the renal endpoint were assessed using Cox\u2010regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three hundred ten patients (median age 75, median BMI 31\u00a0kg\/m<jats:sup>2<\/jats:sup>) were identified. 68% had Stage\u20104 CKD at baseline. Over 4.4\u2010years median follow\u2010up, 128 died and 140 had significant weight\u2010change. During the first year of follow\u2010up, 42 patients lost and 23 gained \u22655% body weight, of whom only 3 had intentionally lost weight. On multivariate regression, significant weight loss\/gain at 1\u2010year was associated with 2.74 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0005) and 2.67 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.003) hazard of subsequent death and with 2.51 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004) and 2.20 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.05) hazard of the renal endpoint respectively. There was no association between baseline eGFR and subsequent weight change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with moderate\/severe CKD experience significant weight\u2010change, but this has no relationship to baseline kidney function. Significant weight\u2010change is associated with higher subsequent mortality and loss of kidney function, but this association is likely significantly affected by confounding.<\/jats:p><\/jats:sec>","DOI":"10.1002\/osp4.723","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T15:18:35Z","timestamp":1700666315000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Weight change in chronic kidney disease: Association with mortality and kidney function"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8180-6732","authenticated-orcid":false,"given":"Richard","family":"Singer","sequence":"first","affiliation":[{"name":"Canberra Health Services Renal Unit  Garran Australian Capital Territory Australia"},{"name":"School of Medicine Australian National University  Acton Australian Capital Territory Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsin\u2010Chia","family":"Huang","sequence":"additional","affiliation":[{"name":"School of Medicine Australian National University  Acton Australian Capital Territory Australia"},{"name":"Canberra Health Services, Respiratory and Sleep Medicine  Garran Australian Capital Territory Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002586"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp640"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.66"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.asn.0000068462.38661.89"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523\u20101755.2001.0590041498.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0272\u20106386(01)80120\u20107"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(21)00591\u20102"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1700459"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.0829"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2011.03468.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.09.015"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2021.01.026"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2023.04.022"},{"key":"e_1_2_8_15_1","first-page":"5","article-title":"KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"3","author":"Eknoyan G","year":"2013","journal-title":"Kidney int"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010150\u20109\u2010200905050\u201000006"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/m20\u20100529"}],"container-title":["Obesity Science &amp; Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/osp4.723","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T21:12:13Z","timestamp":1721769133000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/osp4.723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,22]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/osp4.723"],"URL":"https:\/\/doi.org\/10.1002\/osp4.723","archive":["Portico"],"relation":{},"ISSN":["2055-2238","2055-2238"],"issn-type":[{"value":"2055-2238","type":"print"},{"value":"2055-2238","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,22]]},"assertion":[{"value":"2023-08-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e723"}}