orlistat and Kidney-Diseases

Obesity is currently an epidemic across the globe. Obese patients unable to achieve significant weight loss with lifestyle changes alone may require drug therapy. Clinical trials have shown that orlistat administration may not only lead to weight loss but also protect against type 2 diabetes in around 37% of cases. Orlistat can induce and maintain weight loss, even in patients with comorbid conditions such as hypertension or type 2 diabetes. Recently, orlistat can induce marked weight loss in individuals with chronic kidney disease (CKD). In small numbers of individuals especially those with CKD, orlistat administration may precipitate oxalate nephropathy and renal stone disease. The focus of this article is to review current studies showing impact of orlistat on renal function and outcomes.

Topics: Anti-Obesity Agents; Calcium Oxalate; Humans; Kidney Diseases; Lactones; Obesity; Orlistat

This report describes a case of kidney failure secondary to orlistat, a lipase inhibitor commonly used in the treatment of obesity.. An 80-year-old man with type 2 diabetes who was being treated with orlistat developed rapidly progressive kidney failure. Low-grade albuminuria argued against diabetic nephropathy. Renal biopsy showed tubulointerstitial nephritis associated with numerous calcium oxalate crystals. Enteric hyperoxaluria was attributed to the orlistat treatment. The latter was stopped and the patient received calcium supplements. Six months after orlistat withdrawal, oxaluria was normalized and kidney function stabilized.. Oxalate nephropathy may result from hyperoxaluria secondary to orlistat treatment. This suggests that kidney function and oxaluria be closely monitored in patients taking orlistat.

Topics: Aged, 80 and over; Anti-Obesity Agents; Diabetes Mellitus, Type 2; Humans; Hyperoxaluria; Kidney Diseases; Lactones; Male; Orlistat

Topics: Anti-Obesity Agents; Biopsy; Diet; Female; Humans; Hyperoxaluria; Intestinal Mucosa; Intestines; Kidney; Kidney Diseases; Lactones; Middle Aged; Orlistat; Oxalic Acid; Rheum; Spinacia oleracea

Topics: Anti-Obesity Agents; Canada; Chemical and Drug Induced Liver Injury; Databases, Factual; France; Humans; Kidney Diseases; Lactones; Obesity; Orlistat; Oxalates

Topics: Anti-Obesity Agents; Drug Interactions; Humans; Kidney Diseases; Lactones; Nonprescription Drugs; Orlistat; Pancreatitis

Kidney transplantation in obese patients [body mass index (BMI) >30 kg/m(2)] is associated with a poorer outcome, and these patients are therefore often excluded from transplant waiting lists. Conventional weight loss strategies based on a high fibre, low energy diet and exercise are often unsuitable in the chronic kidney disease (CKD) population. A comprehensive multidisciplinary weight management programme comprising a low fat, reduced energy diet, individual exercise prescription and pharmacotherapy with orlistat 120 mg tds, was initiated to determine whether obese patients with CKD could reach an acceptable weight for transplantation.. Thirty-two patients who completed 12 months in the programme were monitored regularly for weight and waist circumference measures as well as exercise performance tests. Twenty-two patients formed a contemporaneous control group. Exercise performance tests included the 6 min timed walk test (6MTWT), sit to stand transfers in 60 s (STS60), timed up and go 3 m (TUAG) and the Duke's activity status index (DASI), a measure of functional ability.. Friedman's test analyses were performed to assess differences between baseline and 12-month data. Mean body weight reduced by 7.1% from 102.9 kg to 95.7 kg (P<0.001) This equates to a reduction in BMI from 35.7 kg/m(2) at baseline to 33.2 kg/m(2) at 12 months. Waist circumference decreased by 12.9 cm from 112.9 cm to 100.0 cm (P<0.005) at 12 months. The 6MTWT improved by 45% (P<0.001), STS60 by 30% (P<0.001), TUAG by 37% (P<0.001) and DASI by 50% (P<0.001) after 12 months. To date, two of the patients have received live-related renal transplants and an additional seven patients have now been successfully enrolled onto the transplant waiting list.. Preliminary experience from this multidisciplinary programme combining diet, exercise and orlistat suggests that significant weight loss and improved physical functioning can be achieved in obese CKD patients, potentially allowing them the opportunity of kidney transplantation and the associated benefits of this compared with long-term dialysis.

Topics: Adult; Anti-Obesity Agents; Chronic Disease; Combined Modality Therapy; Exercise Therapy; Female; Humans; Kidney Diseases; Lactones; Male; Middle Aged; Obesity; Orlistat; Patient Care Team; Weight Loss

Orlistat is an oral inhibitor of gastrointestinal lipase used for weight reduction in obese patients. Although most adverse drug effects manifest in the gastrointestinal tract, this is the first reported case of orlistat-induced acute kidney injury secondary to acute oxalate nephropathy in a white woman with underlying chronic kidney disease. Acute kidney injury was associated temporally with an increased dose of orlistat and the development of increased fat malabsorption (more frequent loose oily stools). Urine sediment showed abundant calcium oxalate crystals and increased 24-hour urine oxalate concentration. Kidney biopsy showed deposition of calcium oxalate crystals within tubular lumens, consistent with acute oxalate nephropathy. Orlistat therapy was discontinued, and oral fluid intake was increased. A second kidney biopsy performed 1 month later to evaluate the slow resolution of kidney failure did not show calcium oxalate crystals within tubules. A steady improvement in renal function subsequently was observed. Results of a repeated 24-hour urine oxalate collection performed 3 weeks later when kidney function had improved were within normal limits.

Topics: Acute Disease; Calcium Oxalate; Enzyme Inhibitors; Female; Humans; Kidney Diseases; Lactones; Lipase; Middle Aged; Orlistat