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evaluating a multicomponent lifestyle intervention aimed at weight loss on kidney function are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a post hoc analysis of the \u201cPREvenci\u00f3n con DIeta MEDiterr\u00e1nea\u2010Plus\u201d (PREDIMED\u2010Plus) randomized controlled trial, including patients with overweight\/obesity and metabolic syndrome, measured cystatin C and creatinine. Participants were randomly assigned (1:1) to an intensive weight loss lifestyle intervention (intervention group [IG]) consisting of an energy\u2010restricted Mediterranean diet (MedDiet), physical activity promotion and behavioral support, or a control group (CG) receiving ad libitum MedDiet recommendations. The primary outcome was between\u2010group differences in cystatin C\u2013based kidney function (cystatin C\u2013based estimated glomerular filtration rate\u2014eGFRcys\u2014and combined cystatin C\u2013creatinine\u2010based eGFR\u2014eGFRcr\u2010cys) change from baseline to 12 and 36 months. Secondary outcomes included between\u2010group differences in creatinine\u2010based eGFR (eGFRcr) and urinary albumin\u2010to\u2010creatinine ratio (UACR) change and the predictive capacity of these formulas at baseline for new\u2010onset chronic kidney disease (CKD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1909 participants (65\u00a0\u00b1\u00a05 years, 54% men) were included. Twelve\u2010month decline in eGFRcys, eGFRcr\u2010cys, and eGFRcr was greater in the CG compared to the IG, with between\u2010group differences of \u22121.77\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup> [95% confidence interval \u22122.92 to \u22120.63], \u22121.37 [\u22122.22 to \u22120.53], and \u22120.91 [\u22121.74 to \u22120.71], respectively. At 36 months, the decline in eGFRcr\u2010cys and eGFRcr was greater in the CG. No between\u2010group differences in UACR were found. Significant adjusted areas under the curve for baseline eGFRcys and eGFRcr\u2010cys were observed for incident CKD at 36 months, which were similar to those for\u00a0eGFRcr and UACR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In older adults with overweight\/obesity and metabolic syndrome, the PREDIMED\u2010Plus intervention may be an optimal approach to preserve kidney function.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.20038","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T08:23:53Z","timestamp":1735201433000},"page":"141-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effect of an intensive lifestyle intervention on cystatin C\u2013based kidney function in adults with overweight and obesity: From the PREDIMED\u2010Plus trial"],"prefix":"10.1111","volume":"297","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9761-6888","authenticated-orcid":false,"given":"Jos\u00e9 Ignacio","family":"Mart\u00ednez\u2010Montoro","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition Virgen de la Victoria University Hospital  M\u00e1laga Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA)\u2014Plataforma BIONAND  M\u00e1laga Spain"},{"name":"Faculty of Medicine University of M\u00e1laga  M\u00e1laga Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de la Fisiopatolog\u00eda de la Obesidad y la Nutrici\u00f3n (CIBERObn: Physiopathology of Obesity and Nutrition, CB12\/03\/30038), Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-8697","authenticated-orcid":false,"given":"Isabel","family":"Cornejo\u2010Pareja","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Virgen de la Victoria University Hospital  M\u00e1laga Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA)\u2014Plataforma BIONAND  M\u00e1laga Spain"},{"name":"Faculty of Medicine University of M\u00e1laga  M\u00e1laga Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de la Fisiopatolog\u00eda de la Obesidad y la Nutrici\u00f3n (CIBERObn: Physiopathology of Obesity and Nutrition, CB12\/03\/30038), Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"D\u00edaz\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de la Fisiopatolog\u00eda de la Obesidad y la Nutrici\u00f3n (CIBERObn: Physiopathology of Obesity and Nutrition, CB12\/03\/30038), Instituto de Salud Carlos III  Madrid Spain"},{"name":"Nutrition and Mental Health (NUTRISAM) Research Group Universitat Rovira i Virgili (URV)  Reus Spain"},{"name":"Institut d'Investigaci\u00f3 Sanit\u00e0ria Pere Virgili (IISPV)  Reus Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Sureda","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de la Fisiopatolog\u00eda de la Obesidad y la Nutrici\u00f3n (CIBERObn: Physiopathology of Obesity and Nutrition, CB12\/03\/30038), Instituto de Salud Carlos III  Madrid Spain"},{"name":"Health Research Institute of the Balearic Islands (IdISBa)  Palma de Mallorca Spain"},{"name":"Research Group on Community Nutrition &amp; 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