PRAL and obesity due to melanocortin 4 receptor deficiency: Hence, as more scientific evidence and longitudinal studies in this field are required, we prospectively investigated the association between PRAL and NEAP and 1-year changes in two markers of kidney function decline, eGFR and Urine Albumin/Creatinine Ratio (UACR), in a large Spanish cohort of older adults with overweight/obesity and metabolic syndrome (MetS).