Abstract P162: Reductions in Weight and Protein Intake Lower Urinary Albumin Excretion: The PREMIER Study
Background: Obesity is associated with albuminuria, a major risk factor for cardiovascular disease, progression of kidney disease, and mortality. The objective of this study was to examine whether changes in lifestyle behaviors were associated with reductions in urinary albumin excretion (UAE) in individuals with normal renal function.
Methods: This is a secondary analysis of PREMIER, a behavioral intervention trial that randomized individuals to 3 groups: (1) “established,” which emphasized weight loss, physical activity, and reduced sodium and alcohol intake; (2) “established” plus the Dietary Approaches to Stop Hypertension (DASH) diet; (3) “advice only”. Twenty-four hour urine collections were obtained at baseline and 6 month visits. UAE was log transformed, and linear regression was used to evaluate associations between baseline risk factors, treatment group, changes in weight, sodium and protein intake on change in ln(UAE) adjusted for study site, cohort, age, sex, race, and baseline ln(UAE).
Results: Out of 810 participants, 589 (73%) with complete 24-hour urine and weight data were included in our analysis. Baseline median body mass index was 32.3 (interquartile range (IQR) 28.5 to 37.2) and median protein intake was 88.4 mg/day (IQR 71.2 to 108.0). The percentage of individuals with UAE ≥10 mg/day decreased from 17.1% to 11.2% (p=<0.001) after 6 months with no significant difference between treatment groups. After 6 months, median weight change was -6.8 lbs (IQR -15.0 to -1.2) and median change in protein intake was -1.8gm/day (IQR -18.8 to +11.9). Reductions in weight and protein intake were associated with decreases in ln(UAE) in multivariate analyses even after adjusting for change in blood pressure (see table).
Conclusions: In adults with normal renal function, weight loss and decreased protein intake are associated with reductions in UAE. These findings support the need for clinical trials to assess the effects of weight loss on renal outcomes.
- © 2013 by American Heart Association, Inc.