Client weight loss, improves knee Osteoarthritis, kidney function

The kidneys are vital organs that continuously filter the blood, removing metabolic waste products and excess fluid to produce urine. They also help maintain the body’s balance of water, electrolytes and minerals such as sodium, potassium, calcium and phosphorus. In addition, the kidneys play important hormonal roles, including helping regulate blood pressure, stimulate red blood cell production and activate vitamin D for healthy bones

Osteoarthritis of the knee involves progressive changes to the joint structures, particularly the articular cartilage, subchondral bone and surrounding tissues. As the joint becomes less able to distribute load efficiently, movement can become painful and restricted, affecting normal biomechanics and mechanical function. Pain, stiffness and reduced joint range of motion may alter gait and loading patterns, often leading to compensatory movement and reduced physical activity. Over time, this can contribute to loss of muscle strength and further impair functional capacity, particularly during weight-bearing activities such as walking, stair climbing and squatting.

Presentation
The client 63 year old female menopausal client, hypertensive, overweight, and diagnosed with knee osteoarthritis, presenting with an antalgic gait, a walking pattern that develops to avoid pain due to knee pain. The client signed up to my combined 6 months Nutritional Therapy and Personal Training program which offers unrivalled professional support and safeguarding.

Personal training
For a client with knee osteoarthritis, working with a CIMSPA UK–registered Personal Trainer can provide valuable structure, supervision and individualisation. NICE identifies tailored therapeutic exercise and weight management as core components of osteoarthritis management, with supervised exercise specifically recommended for consideration. A CIMSPA Personal Trainer like myself, can assess the client’s current physical capabilities and develop a progressive, personalised exercise programme aimed at improving lower-limb strength, joint stability, mobility, balance and overall physical function, while adapting exercises according to pain, movement limitations and progress. CIMSPA’s professional standards specifically require Personal Trainers to plan and deliver personalised programmes, adapt guidance to individual needs and recognise when referral to an appropriate healthcare professional is required. Take a look at my Personal Training page.

For someone whose knee pain has resulted in an antalgic gait, this individualised approach is particularly important. Progressive strengthening of the muscles supporting the knee and hip, combined with appropriate aerobic activity and functional movements, can help improve the capacity to perform everyday activities such as walking, climbing stairs and rising from a chair. Consistent exercise may also help break the cycle of pain; reduced activity; muscle weakness and reduced function. In this context, the Personal Trainer’s role is not to treat or diagnose the osteoarthritis, but to provide appropriately tailored exercise, monitor progression and support long-term adherence, while working alongside healthcare professionals where additional assessment or treatment is required. When combined with nutritional Therapy, the combination can life significant because every intervention is personalised to the client.

Started with Nutritional Therapy
When we began working together on 24 May 2026, her most recent eGFR available was 63.48 mL/min/1.73 m² (26 June 2026). Her previous results had shown a gradual decline from 95.99 in January 2023 to 84.53 in December 2024, followed by the more pronounced reduction to 63.48. eGFR is an estimate rather than a direct measurement of filtration and can be influenced by factors including creatinine, muscle mass, dietary intake and biological variation. ^(1–3). The latest result, 81 mL/min/1.73 m² on 3 August 2026, represents an increase of approximately 28% from the June result (Fig.3). This is an encouraging change, although a single improvement does not by itself establish a sustained change in underlying kidney function; trends over time are more informative. Guidelines recommends assessing potential sources of error and variability when interpreting changes in eGFR, such as using the same labs ^(2,3), which we did. Client data shared with consent.

Reasons for the kidney function decline
Kidney function can gradually decline over time due to a combination of factors. The most common contributors are high blood pressure and impaired blood-glucose regulation/diabetes, both of which can progressively damage the kidney’s blood vessels and filtering structures. Other factors include cardiovascular disease, excess body weight and metabolic dysfunction, recurrent kidney injury or infections, kidney stones, certain inflammatory or autoimmune conditions, and prolonged exposure to kidney-toxic medications. Regular use of NSAIDs such as ibuprofen can also contribute to kidney injury, particularly in susceptible individuals or during dehydration. Dehydration was ruled out as a result of analysing the clients past blood results, as the key markers which may rise as a result of frank dehydration, were not showing.

Reasons for the Osteoarthritis
Weight management can be particularly important, as excess body weight increases mechanical loading on weight-bearing joints such as the knees. Adipose tissue is also metabolically active and can contribute to inflammatory signalling, meaning that nutritional strategies which achieve sustainable fat loss may provide both mechanical and metabolic benefits for osteoarthritis. Over the 3 months, the client has transiently lost approximately 7 kilos, without too much efforts and has done so naturally and sustainable, allowing for the body and muscle to adapt to the personal training regime. A 7kg reduction in body weight (7.4%) from 95 kg to 88 kg (Fig.4), represents a meaningful improvement in body weight for a 63-year-old client with osteoarthritis. From a functional medicine perspective, this reduction may provide both mechanical and metabolic benefits, reducing load on the weight-bearing knee while potentially improving metabolic and inflammatory factors associated with osteoarthritis. The combination of nutritional therapy and progressive exercise can therefore support improved mobility, physical function and quality of life.

Nutritional improves markers
After 3 months Nutritional Therapy, subjective feedback has revealed that her knee osteoarthritis has improved significantly. You can see the significant improvement in kidney function in the graph above.

CLIENT FEEDBACK “My Osteoarthritis has improved a lot. I was in a fair-to-severe amount of pain everyday. I can walk upstairs more easily. Now I would say, my knee is uncomfortable than painful. It still feels more delicate, stiff at times and i have mild pain especially if I stand or walk. I was getting to the end of my tether, and becoming unable to cope with the pain level some days. Now its a lot more manageable, and so quality of life has improved.”

Functional medicine
From a functional medicine perspective, the focus is not simply on the eGFR number but on identifying and addressing modifiable factors that may influence kidney health, including metabolic health, blood pressure, dietary pattern, physical activity, medication and supplement use, hydration and other relevant lifestyle factors. Current kidney guidelines similarly recommend a comprehensive approach incorporating physical activity, healthy body weight and cardiovascular risk reduction ^(2,4). Importantly, eGFR should be interpreted alongside other markers which can provide complementary information about kidney damage and future risk. From a functional medicine perspective, Nutritional Therapy for Osteoarthritis focuses on addressing the metabolic and inflammatory factors that can contribute to joint degeneration, pain and reduced function. Rather than focusing solely on the joint itself, the approach considers the interaction between body weight, inflammation, blood glucose regulation, gut health and nutrient status. As you can see, the results speaks for themselves.

Guidelines
UK guidelines recommend combining GFR assessment with albuminuria assessment rather than relying on eGFR alone ^(2,5). The improvement from 63.48 to 81 following the commencement of work on 24 May 2026 provides a positive marker to monitor, while continued testing will help determine whether this represents a sustained improvement. The objective is therefore not simply to achieve a higher number, but to support stable kidney function and favourable metabolic and cardiovascular health over the longer term. ^(2,4). With regards the osteoarthritis, our diet and lifestyle recommendations are frequently reviewed and updated depending on progress, but suffice to say that the prognosis looks encouraging!

If you, or someone you know, is struggling with osteoarthritis and affecting their quality of life and mental health, get in touch with me for a free 10 min chat before committing to my programs.

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