Effects of Body-Weight Loss and Captopril Treatment on Proteinuria Associated with Obesity

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Abstract
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.

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