{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T20:01:37Z","timestamp":1788811297773,"version":"build-2803163510"},"reference-count":71,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Obesity and chronic kidney disease (CKD) are highly prevalent conditions with substantial public health impacts; their co\u2010existence is common and associated with an aggravated risk for adverse outcomes. We conducted an updated systematic review and meta\u2010analysis to evaluate the effects of weight\u2010loss interventions on kidney, cardiometabolic and anthropometric outcomes in overweight or obese adults with CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Systematic searches in PubMed, CENTRAL and Embase databases were performed up to August 2025. Randomised\u2010controlled trials evaluating the effects of any weight\u2010loss interventions (lifestyle, pharmacological, surgical approaches) in overweight or obese patients with any stage of CKD were included. Primary endpoints were kidney and cardiovascular outcomes and mortality; secondary endpoints included anthropometric parameters and blood pressure (BP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010two studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911\u2009017) were included in qualitative and 27 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097015) in quantitative analysis. Cardiovascular outcomes and mortality data were lacking. The estimated glomerular filtration rate (eGFR) demonstrated a non\u2010significant upward trend following lifestyle and pharmacological interventions (incretin\u2010based therapies) and a significant increase following bariatric surgery (MD: 6.09\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      ;95% CI: [3.66, 8.52],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20091%). Incretin\u2010based therapies achieved a 41% reduction in urine albumin\u2010to\u2010creatinine ratio compared with placebo (95% CI: [29%, 52%],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200986%). Anthropometric parameters, including weight, body\u2010mass index and waist circumference, improved across all intervention categories, with lifestyle\u2010based approaches most extensively studied (weight\u2010loss MD: \u20134.13\u2009kg; 95% CI:[\u22126.49, \u20131.76],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200983%). Systolic and diastolic BP showed modest, non\u2010significant reductions following lifestyle interventions (SBP MD: \u22123.10\u2009mm Hg; 95% CI: [\u22127.59, 1.38],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200945%), while data for pharmacological and surgical approaches were limited and definitive conclusions cannot be made.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In CKD patients with overweight or obesity, all types of interventions (lifestyle, pharmacological, surgical) are effective for weight\u2010loss. Incretin\u2010based therapies confer additional nephroprotective effects by significantly reducing albuminuria. Uncertainty persists for the remaining outcomes, highlighting the need for additional research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70997","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T01:19:51Z","timestamp":1782177591000},"page":"8266-8276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Weight\u2010Loss Interventions on Kidney, Cardiometabolic and Anthropometric Outcomes in Adults With\n                    <scp>CKD<\/scp>\n                    and Overweight or Obesity: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7359-6617","authenticated-orcid":false,"given":"Anastasia","family":"Stamatiou","sequence":"first","affiliation":[{"name":"First Department of Nephrology Aristotle University of Thessaloniki, Hippokration Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieta P.","family":"Theodorakopoulou","sequence":"additional","affiliation":[{"name":"First Department of Nephrology Aristotle University of Thessaloniki, Hippokration Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fotini","family":"Iatridi","sequence":"additional","affiliation":[{"name":"First Department of Nephrology Aristotle University of Thessaloniki, Hippokration Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5853-1352","authenticated-orcid":false,"given":"Theocharis","family":"Koufakis","sequence":"additional","affiliation":[{"name":"Second Propaedeutic Department of Internal Medicine Aristotle University of Thessaloniki, Hippokration Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalliopi","family":"Kotsa","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism and Diabetes Centre, First Department of Internal Medicine Aristotle University of Thessaloniki, AHEPA University Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantelis","family":"Sarafidis","sequence":"additional","affiliation":[{"name":"First Department of Nephrology Aristotle University of Thessaloniki, Hippokration Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(24)00316\u20104"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(25)00355\u20101"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)00933\u20104"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMOA1614362"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaf231"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0085\u20102538(24)00110\u20108"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0176616"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfae207"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013119"},{"key":"e_1_2_8_11_1","unstructured":"RoB 2: A Revised Cochrane Risk\u2010of\u2010Bias Tool for Randomized Trials | Cochrane Bias 2026."},{"key":"e_1_2_8_12_1","unstructured":"GRADE Working Group GRADE Handbook | Cochrane 2026."},{"key":"e_1_2_8_13_1","unstructured":"J. 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