13 / 20
Volume 6, Issue 9(Suppl)
J Obes Weight Loss Ther 2016
ISSN: 2165-7904 JOWT, an open access journal
Page 36
Notes:
Obesity 2016
December 08-10, 2016
conferenceseries
.com
Obesity & Weight Management
December 08-10, 2016 Dallas, USA
10
th
International Conference and Exhibition on
Treatment of metabolic acidosis in chronic kidney disease yields better weight control with fruits and
vegetables than with currently recommended sodium-based alkali therapy
Donald E Wesson
1, 2, 4
, Nimrit Goraya
1, 2
, Jan Simoni
3
and
Jessica Pruszynski
1
1
Baylor Scott and White Health, USA
2
Texas A&M HSC College of Medicine, USA
3
Texas Tech University Health Sciences Center, USA
4
Diabetes Health and Wellness Institute, USA
Background:
Current guidelines recommend sodium-based alkali therapy for metabolic acidosis in chronic kidney disease (CKD)
but recent data support that base-producing fruits and vegetables (F+V) also improve metabolic acidosis in CKD. Because CKD
increases cardiovascular risk, weight reduction in overweight CKD patients appears desirable given its cardiovascular and other
benefits. A diet high in F+V might promote weight reduction as well as improve metabolic acidosis in CKD.
Methods:
We randomized 108 subjects with CKD stage 3 estimated glomerular filtration rate (30-59 ml/min/1.73 m
2
), metabolic
acidosis with plasma total CO
2
(PTCO
2
) >22 but <24 mM, and baseline BMI >25 as follows: F+V (n=36) added to reduce dietary
potential renal acid load (PRAL) 50%, oral NaHCO
3
(HCO
3
, n=36) to reduce PRAL 50%, or no alkali (Usual Care, n=36). All received
standard kidney protection measures and were followed for 5 years.
Results:
Baseline PTCO
2
(23.0±0.6, 23.1±0.6, and 23.0±0.5, p=0.62) and BMI (28.8±2.1, 28.3±2.0, and 28.2±2.1, p=0.45) were not
different among F+V, HCO
3
, and Usual Care, respectively. Five-year PTCO
2
was higher in HCO
3
(23.9±0.4 mM) and F+V (23.8±0.4
mM) than Usual Care (21.9±0.4 mM, p <0.01 vs. HCO3 and F+V). By contrast, five-year BMI was lower (p<0.03) in F+V (26.6±1.7)
than both HCO
3
(28.4±1.9) and Usual Care (27.8±1.7).
Conclusions:
Treating CKD patients with either NaHCO
3
or F+V improved metabolic acidosis similarly but BMI was lowest with
F+V. Better weight control with F+V than NaHCO
3
, the latter being the currently recommended treatment option, supports F+V as
the preferred treatment strategy for metabolic acidosis in overweight CKD patients.
Biography
Donald E Wesson, MD, FACP is currently Professor of Medicine and the Vice Dean of Texas A&M University College of Medicine in Temple, Texas. Prior to this position, he
was the S C Arnett Professor of Medicine and Chairman of the Department of Internal Medicine and Physiology at Texas Tech University Health Sciences Center and had
been Associate Professor of Medicine at the Baylor College of Medicine where he was Assistant Chief of the Nephrology Section at the Houston VA Hospital. He received
his undergraduate degree from the Massachusetts Institute of Technology. He earned his Medical Degree from Washington University School of Medicine and completed
his Residency and Internship at Baylor College of Medicine. He is the recipient of multiple teaching awards at Baylor and Texas Tech.
donald.wesson@BSWHealth.orgDonald E Wesson et al., J Obes Weight Loss Ther 2016, 6:9(Suppl)
http://dx.doi.org/10.4172/2165-7904.C1.042