Abstract:Objective: To examine the effects of Orlistat on renal function and weight loss in obese patients at the Brooklyn VA Hospital.Background: Obesity is fast becoming a worldwide epidemic. Orlistat has widely been used in the US for the management of obesity since being approved by the FDA in 1999. Recent studies indicated that Orlistat has been associated with hepatic dysfunction. Consequently in May 2010, the FDA approved a revised label for Xenical to include new safety information about cases of severe liver injury with its use. More recently, reports have suggested oxalate nephropathy and acute kidney injury associated with Orlistat use. To date, there have been no large studies in the US, demonstrating an association between Orlistat and renal dysfunction.Methods: We conducted a retrospective case control analysis of the effect of Orlistat in obese patients. We included patients on Orlistat who were enrolled in the MOVE clinic (Managing Overweight/Obesity in Veterans Everywhere) at the Brooklyn VA Hospital, NY from October 2006 to May 2012. Exclusion criteria were pre-existing renal dysfunction, chronic kidney disease, use of drugs with potential nephrotoxicity or the use of Orlistat for less than six months. Patients were provided education and consultation. Consistency in renal function (BUN, Creatinine & eGFR) over one year were analyzed with the intraclass correlation coefficient (ICC). Differences in weight loss were compared between the groups treated with Orlistat to that of a matched control group not on Orlistat using analysis of variance. Results: Sixty-six patients were enrolled in the study, thirty on Orlistat and thirty-six not on Orlistat. Data were analyzed with SPSS Version 15. There were no differences at baseline between groups in age, gender, race or Body Mass Index (BMI). Change in BMI from baseline to 6 months was significant in the Orlistat group (p<0.001), but not in the group receiving education and consultation alone. This change was sustained over one year. BUN, Creatinine and eGFR maintained consistency in patients on Orlistat over the study period (ICC range 0.83-0.90, p <0.001).บทสรุป: Orlistat ไม่ มีผลใด ๆ ตรง nephrotoxic วัดจาก BUN, Creatinine และ eGFR มากกว่าหนึ่งปีของการรักษา ผู้ป่วยใน Orlistat สูญเสียน้ำหนักมากขึ้น และสามารถรักษาน้ำหนักมีประสิทธิภาพมากกว่าผู้ป่วยที่รับการศึกษาและให้คำปรึกษาเพียงอย่างเดียวไม่เปิดเผย: BB, DS, MC, MP
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