Weight loss and proteinuria.

The level of proteinuria is one of the most determinant risk factors for the progression of proteinuric renal diseases. Several studies have shown that weight loss, either induced by low calorie diets, physical exercise, or bariatric surgery is accompanied by an important antiproteinuric effect. Reduction in proteinuria is already observed after a few weeks from the onset of weight loss and it is evident even in patients with modest weight losses. The magnitude of body weight loss and proteinuria decrease show a significant correlation. Reduction in proteinuria by weight loss has been described in obesity-induced glomerulopathy, obese diabetic patients and overweight or obese patients with different types of chronic proteinuric nephropathies. Attenuation of the obesity-induced glomerular hyperfiltration, decrease in the activity of renin-angiotensin-aldosterone system and modifications in the serum concentrations of adipocyte-derived cytokine are likely to be involved in the anti-proteinuric effect of weight loss, together with a better control of blood pressure, and improvement of serum lipid profile and insulin sensitivity.