K Weight-reduction strategies may result in other health benefits to CKD patients including reduction in urine albumin or protein levels, improved lipid profile and increased insulin sensitivity. The prevalence of obesity is very high in Western countries and is increasing rapidly in developed and developing countries around the world. A strong relationship exists between body weight (usually defined as BMI) and BP levels in the general population.50 52 Compared with a person of normal weight, individuals who are overweight or obese tend to have higher BP levels, abnormalities in a range of other cardiovascular parameters (e.g., dyslipidemia52 ), and an increased risk of cardiovascular events. Weight and BP. A weight-reducing diet has been clearly demonstrated to lower BP in overweight individuals in the general population. A systematic review53 published in 2006 identified 14 trials assessing the effects of dietary modification on BP in the general population, all but two of which assessed the effects of weight reduction in overweight persons. Many of the 14 trials also included other modifications to diet (e.g., increased fruit and vegetable intake and salt reduction) and lifestyle (e.g., increased exercise). Trials were 8 to 52 weeks in duration and mostly included participants with elevated BP levels. The quality of the trials was generally suboptimal. Overall, dietary modification reduced systolic BP by 6.0 mm Hg (95% confidence interval [CI] 3.4 8.6) and diastolic BP by 4.8 mm Hg (95% CI 2.7 6.9). High levels of heterogeneity in the trial results were observed. The available data regarding the effects of weight loss in CKD patients has been systematically reviewed by Nava- neethan et al.54 Only two randomized trials were identified but 11 observational studies were also included. A range of surgical and non-surgical weight-loss interventions were assessed. 