We have read with interest the recent published paper in Kidney International Reports entitled "Obesity Weight Loss Phenotypes in CKD: Findings From the Chronic Renal Insufficiency Cohort Study."1Harhay M.N. Kim Y. Milliron B.J. Robinson L.F. CRIC Study InvestigatorsObesity weight loss phenotypes in CKD: findings from the chronic renal insufficiency cohort study.Kidney Int Rep. 2023; 8: 1352-1362https://doi.org/10.1016/j.ekir.2023.04.022Google Scholar The authors of this interesting manuscript revealed that the pattern of weight loss (rapid vs. slow) and concurrent trends of nutritional, hemodynamic, and body composition indicators are important for understanding long-term mortality risk in persons with obesity and chronic kidney disease (CKD). Currently, obesity has been clearly identified as a cause of CKD with different phenotypes.2Rico-Fontalvo J. Daza-Arnedo R. Rodríguez-Yanez T. et al.Obesidad y enfermedad renal crónica. Una mirada desde los mecanismos fisiopatológicos: revisión narrativa.Dial Trasplant. 2022; 10: 97-107https://doi.org/10.56867/32Google Scholar The manuscript by Harhay et al.1Harhay M.N. Kim Y. Milliron B.J. Robinson L.F. CRIC Study InvestigatorsObesity weight loss phenotypes in CKD: findings from the chronic renal insufficiency cohort study.Kidney Int Rep. 2023; 8: 1352-1362https://doi.org/10.1016/j.ekir.2023.04.022Google Scholar lacks in information regarding the urine albumin-to-creatinine excretion ratio, crucial for the diagnosis and prognosis of persons with CKD in terms of renal progression, independent marker of cardiovascular disease and mortality.3Visseren F.L.J. Mach F. Smulders Y.M. et al.2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.Eur Heart J. 2021; 42: 3227-3337https://doi.org/10.1093/eurheartj/ehab484Google Scholar In addition, it has been previously found that in patients with obesity and CKD, estimated glomerular filtration rate is not a good method with a high variability that may reach to 30%, suggesting that in persons with obesity, measured glomerular filtration rate may avoid the estimation errors.4Porrini E. Ruggenenti P. Luis-Lima S. et al.Estimated GFR: time for a critical appraisal.Nat Rev Nephrol. 2019; 15: 177-190https://doi.org/10.1038/s41581-018-0080-9Google Scholar For all these mentioned reasons, we surmise that the results of the present study in Kidney International Reports should be at least adjusted by the baseline albumin-to-creatinine excretion ratio. Obesity Weight Loss Phenotypes in CKD: Findings From the Chronic Renal Insufficiency Cohort StudyKidney International ReportsVol. 8Issue 7PreviewAlthough people with chronic kidney disease (CKD) and obesity have important motivations to lose weight, weight loss is also associated with health risks. We examined whether patterns of change in systolic blood pressure (SBP), serum albumin level, and fat-free mass (FFM) can help to differentiate between healthy and high-risk weight loss in this population. Full-Text PDF Open Access