Praga M, Hernández E, Andrés A, León M, Ruilope L M, Rodicio J L
Nephrology Department, Hospital 12 de Octubre, Madrid, Spain.
Nephron. 1995;70(1):35-41. doi: 10.1159/000188541.
We have identified 17 obese patients (body mass index, BMI, 37.9 +/- 4.1) with proteinuria > 1 g/day (1.3-6.4 g/24 h, mean 3.1 +/- 1.7). Their age was 34-70 years (48.3 +/- 10); 11 were females and 6 males. Six patients had only one functioning kidney and a sleep apnea syndrome had been diagnosed in 5. Renal biopsies, obtained in 5 cases, showed focal glomerulosclerosis in 2 cases, minimal changes in 2 and mesangial proliferation in 1. Nine patients (group 1) were treated with hypocaloric diets; body weight significantly decreased (BMI 37.1 +/- 3, 34 +/- 3.5 and 32.6 +/- 3.2 at 0, 6 and 12 months, respectively) as well as proteinuria (2.9 +/- 1.7, 1.2 +/- 1 and 0.4 +/- 0.6 g/24 h). There was a significant correlation between body weight loss and decrease in proteinuria (r = 0.69, p < 0.05). Eight patients (group 2) were treated with captopril, without dietary changes. BMI remained stable but proteinuria showed a dramatic decrease, similar to that in group 1 (3.4 +/- 1.7, 1.2 +/- 0.9 and 0.7 +/- 1 g/24 h, respectively). Renal function remained stable in both groups. In summary, both body weight loss and captopril treatment can induce a sharp decrease in obesity-related proteinuria.
我们已确定17例肥胖患者（体重指数，BMI，37.9±4.1），蛋白尿>1g/天（1.3 - 6.4g/24小时，平均3.1±1.7）。他们的年龄为34 - 70岁（48.3±10）；11例为女性，6例为男性。6例患者仅有一个功能肾，5例被诊断为睡眠呼吸暂停综合征。5例患者进行了肾活检，2例显示局灶性肾小球硬化，2例显示轻微病变，1例显示系膜增生。9例患者（第1组）接受低热量饮食治疗；体重显著下降（0、6和12个月时的BMI分别为37.1±3、34±3.5和32.6±3.2），蛋白尿也显著下降（2.9±1.7、1.2±1和0.4±0.6g/24小时）。体重减轻与蛋白尿减少之间存在显著相关性（r = 0.69，p < 0.05）。8例患者（第2组）接受卡托普利治疗，饮食未改变。BMI保持稳定，但蛋白尿显著下降，与第1组相似（分别为3.4±1.7、1.2±0.9和0.7±1g/24小时）。两组肾功能均保持稳定。总之，体重减轻和卡托普利治疗均可导致肥胖相关蛋白尿急剧下降。
