Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)

Introduction: Low energy diets (LEDs) may slow disease progression; however, their effects are under researched in chronic kidney disease (CKD). This study evaluated the safety and feasibility of an LED weight management program in adults with obesity and CKD. Methods: This multicenter 6-month rando...

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Main Authors: Marguerite M. Conley, Hannah L. Mayr, Kirsten S. Hepburn, Justin J. Holland, David W. Mudge, Tammy J. Tonges, Richard S. Modderman, Sally A. Gerzina, David W. Johnson, Andrea K. Viecelli, Helen L. MacLaughlin
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Kidney International Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468024925002451
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author Marguerite M. Conley
Hannah L. Mayr
Kirsten S. Hepburn
Justin J. Holland
David W. Mudge
Tammy J. Tonges
Richard S. Modderman
Sally A. Gerzina
David W. Johnson
Andrea K. Viecelli
Helen L. MacLaughlin
author_facet Marguerite M. Conley
Hannah L. Mayr
Kirsten S. Hepburn
Justin J. Holland
David W. Mudge
Tammy J. Tonges
Richard S. Modderman
Sally A. Gerzina
David W. Johnson
Andrea K. Viecelli
Helen L. MacLaughlin
author_sort Marguerite M. Conley
collection DOAJ
description Introduction: Low energy diets (LEDs) may slow disease progression; however, their effects are under researched in chronic kidney disease (CKD). This study evaluated the safety and feasibility of an LED weight management program in adults with obesity and CKD. Methods: This multicenter 6-month randomized controlled trial (RCT) involved adults with CKD Kidney Disease: Improving Global Outcomes stages G1 to G3b, obesity, and proteinuria, randomized 1:1 into 2 groups. The LED group followed a 3-month 800 to 900 kcal/d LED, with dietitian support, then a 3-month weight maintenance phase with exercise and healthy eating support. The usual care (UC) group received standard clinic weight loss support. Primary outcomes were safety (serious adverse events [SAEs]) and feasibility (≥2 of recruitment rate ≥ 25%, LED group retention rate ≥ 75%, and ≥ 30% of LED group achieving ≥ 10 kg weight loss at 3 months). Secondary outcomes included changes in anthropometry, clinical measures, patient-reported outcomes, and participant experiences. Results: Forty-nine participants (median age 51 years, 57% male) consented. SAEs were low and comparable as follows: 2 in the LED group (hypoglycemia and acute kidney injury) and 2 in the UC group (hypoglycemia), all requiring hospitalization. Feasibility was met for recruitment (46%) and weight loss (46% achieved ≥ 10 kg loss) but not for retention (67% retained). At 6 months, median (IQR) weight change was −9.0 kg (−12 to −7) in the LED group and 0 kg (−4 to 2) in the UC group (P < 0.001). Conclusion: LEDs under professional guidance are safe and feasible for weight loss in adults with obesity and CKD Kidney Disease: Improving Global Outcomes stages G1 to G3b. A definitive RCT to assess their effects on clinical outcomes and CKD progression is warranted.
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spelling doaj-art-e7665d779aea41cfb36a6688697db1582025-08-20T03:24:16ZengElsevierKidney International Reports2468-02492025-07-011072153216410.1016/j.ekir.2025.04.021Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)Marguerite M. Conley0Hannah L. Mayr1Kirsten S. Hepburn2Justin J. Holland3David W. Mudge4Tammy J. Tonges5Richard S. Modderman6Sally A. Gerzina7David W. Johnson8Andrea K. Viecelli9Helen L. MacLaughlin10School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Correspondence: Marguerite M. Conley, Department of Nutrition and Dietetics, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Queensland 4102 Queensland, Australia.Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Queensland, AustraliaKidney Health Service, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, AustraliaSchool of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, AustraliaDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia; Redland Hospital, Brisbane, Queensland, AustraliaConsumer Co-researcher, Brisbane, Queensland, AustraliaFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park South Australia, Australia; Department of Physiotherapy, Sunshine Coast University Hospital, Birtinya, Queensland, AustraliaDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, AustraliaDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, AustraliaDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, AustraliaSchool of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Queensland, Australia; Nutrition Research Collaborative, Dietetics and Foodservices, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, AustraliaIntroduction: Low energy diets (LEDs) may slow disease progression; however, their effects are under researched in chronic kidney disease (CKD). This study evaluated the safety and feasibility of an LED weight management program in adults with obesity and CKD. Methods: This multicenter 6-month randomized controlled trial (RCT) involved adults with CKD Kidney Disease: Improving Global Outcomes stages G1 to G3b, obesity, and proteinuria, randomized 1:1 into 2 groups. The LED group followed a 3-month 800 to 900 kcal/d LED, with dietitian support, then a 3-month weight maintenance phase with exercise and healthy eating support. The usual care (UC) group received standard clinic weight loss support. Primary outcomes were safety (serious adverse events [SAEs]) and feasibility (≥2 of recruitment rate ≥ 25%, LED group retention rate ≥ 75%, and ≥ 30% of LED group achieving ≥ 10 kg weight loss at 3 months). Secondary outcomes included changes in anthropometry, clinical measures, patient-reported outcomes, and participant experiences. Results: Forty-nine participants (median age 51 years, 57% male) consented. SAEs were low and comparable as follows: 2 in the LED group (hypoglycemia and acute kidney injury) and 2 in the UC group (hypoglycemia), all requiring hospitalization. Feasibility was met for recruitment (46%) and weight loss (46% achieved ≥ 10 kg loss) but not for retention (67% retained). At 6 months, median (IQR) weight change was −9.0 kg (−12 to −7) in the LED group and 0 kg (−4 to 2) in the UC group (P < 0.001). Conclusion: LEDs under professional guidance are safe and feasible for weight loss in adults with obesity and CKD Kidney Disease: Improving Global Outcomes stages G1 to G3b. A definitive RCT to assess their effects on clinical outcomes and CKD progression is warranted.http://www.sciencedirect.com/science/article/pii/S2468024925002451chronic kidney diseaselow energy dietmeal replacementobesityweight lossweight management
spellingShingle Marguerite M. Conley
Hannah L. Mayr
Kirsten S. Hepburn
Justin J. Holland
David W. Mudge
Tammy J. Tonges
Richard S. Modderman
Sally A. Gerzina
David W. Johnson
Andrea K. Viecelli
Helen L. MacLaughlin
Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)
Kidney International Reports
chronic kidney disease
low energy diet
meal replacement
obesity
weight loss
weight management
title Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)
title_full Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)
title_fullStr Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)
title_full_unstemmed Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)
title_short Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)
title_sort low energy diets for obesity and ckd slow ckd randomized feasibility study
topic chronic kidney disease
low energy diet
meal replacement
obesity
weight loss
weight management
url http://www.sciencedirect.com/science/article/pii/S2468024925002451
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