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

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

doi:10.1016/j.ekir.2025.04.021

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

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › Research › peer-review

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Abstract

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.

Original language	English
Pages (from-to)	2153-2164
Number of pages	12
Journal	Kidney International Reports
Volume	10
Issue number	7
DOIs	https://doi.org/10.1016/j.ekir.2025.04.021
Publication status	Published - Jul 2025
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)Final published version, 642 KBLicence: CC BY

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@article{5339442379074381be6cfbaeff3c14ca,

title = "Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)",

abstract = "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.",

author = "Conley, {Marguerite M} and Mayr, {Hannah L} and Hepburn, {Kirsten S} and Holland, {Justin J} and Mudge, {David W} and Tonges, {Tammy J} and Modderman, {Richard S} and Gerzina, {Sally A} and Johnson, {David W} and Viecelli, {Andrea K} and MacLaughlin, {Helen L}",

note = "{\textcopyright} 2025 International Society of Nephrology. Published by Elsevier Inc.",

year = "2025",

month = jul,

doi = "10.1016/j.ekir.2025.04.021",

language = "English",

volume = "10",

pages = "2153--2164",

journal = "Kidney International Reports",

issn = "2468-0249",

publisher = "Elsevier",

number = "7",

}

TY - JOUR

T1 - Low Energy Diets for Obesity and CKD (SLOW-CKD Randomized Feasibility Study)

AU - Conley, Marguerite M

AU - Mayr, Hannah L

AU - Hepburn, Kirsten S

AU - Holland, Justin J

AU - Mudge, David W

AU - Tonges, Tammy J

AU - Modderman, Richard S

AU - Gerzina, Sally A

AU - Johnson, David W

AU - Viecelli, Andrea K

AU - MacLaughlin, Helen L

PY - 2025/7

Y1 - 2025/7

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=105005434097&partnerID=8YFLogxK

U2 - 10.1016/j.ekir.2025.04.021

DO - 10.1016/j.ekir.2025.04.021

M3 - Article

C2 - 40677318

AN - SCOPUS:105005434097

SN - 2468-0249

VL - 10

SP - 2153

EP - 2164

JO - Kidney International Reports

JF - Kidney International Reports

IS - 7

ER -

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

Abstract

UN SDGs

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Nutrition for Chronic Disease and Disability: Research to improve health related quality of life and bring forward the under-represented voice

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

Abstract

UN SDGs

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Nutrition for Chronic Disease and Disability: Research to improve health related quality of life and bring forward the under-represented voice

Cite this