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Bariatric surgery and progression of chronic kidney disease.
Surg Obes Relat Dis. 2009 Nov-Dec; 5(6):662-5.SO

Abstract

BACKGROUND

Obesity is an independent predictor for the development and progression of chronic kidney disease (CKD). The effect of weight reduction on the progression of kidney disease in patients with pre-existing CKD is unclear.

METHODS

We conducted a retrospective study at a U.S. university hospital of patients with stage 3 CKD (glomerular filtration rate [GFR] 30-59 mL/min/1.73 m(2)) who had undergone bariatric surgery. The renal function of the included patients was recorded for a 2-year period after surgery to analyze the rate of loss or improvement in renal function. The estimated GFR was calculated using the Modification of Diet in Renal Disease 4-variable formula. Patients who developed acute renal failure in the postoperative period were excluded.

RESULTS

A total of 25 patients with stage 3 CKD were included. Their average body mass index at surgery was 49.8 kg/m(2), the mean GFR was 47.9 mL/min/1.73 m(2), and the mean serum creatinine was 1.4 mg/dL. The body mass index had decreased to 38.4 kg/m(2) (paired t test, P < .001) at the end of 6 months and to 34.5 kg/m(2) (P < .001) at the end of 12 months. The mean systolic blood pressure had decreased from 133 +/- 13 to 128 +/- 17 mm Hg at the end of 12 months. The mean GFR at 6 months of follow-up had improved to 56.6 mL/min/1.73 m(2) (P < .001) and to 61.6 mL/min/1.73 m(2) (P < .001) at 12 months.

CONCLUSION

The renal function of patients with CKD might improve after bariatric surgery. Larger and long-term studies are warranted to further analyze the effect of bariatric surgery on proteinuria and hard end-points such as the development of end-stage renal disease.

Authors+Show Affiliations

Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, Ohio 44195, USA. navanes@ccf.orgNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19359221

Citation

Navaneethan, Sankar D., and Hans Yehnert. "Bariatric Surgery and Progression of Chronic Kidney Disease." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 5, no. 6, 2009, pp. 662-5.
Navaneethan SD, Yehnert H. Bariatric surgery and progression of chronic kidney disease. Surg Obes Relat Dis. 2009;5(6):662-5.
Navaneethan, S. D., & Yehnert, H. (2009). Bariatric surgery and progression of chronic kidney disease. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 5(6), 662-5. https://doi.org/10.1016/j.soard.2009.01.006
Navaneethan SD, Yehnert H. Bariatric Surgery and Progression of Chronic Kidney Disease. Surg Obes Relat Dis. 2009 Nov-Dec;5(6):662-5. PubMed PMID: 19359221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bariatric surgery and progression of chronic kidney disease. AU - Navaneethan,Sankar D, AU - Yehnert,Hans, Y1 - 2009/01/28/ PY - 2009/01/06/received PY - 2009/01/11/revised PY - 2009/01/12/accepted PY - 2009/4/11/entrez PY - 2009/4/11/pubmed PY - 2010/3/5/medline SP - 662 EP - 5 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 5 IS - 6 N2 - BACKGROUND: Obesity is an independent predictor for the development and progression of chronic kidney disease (CKD). The effect of weight reduction on the progression of kidney disease in patients with pre-existing CKD is unclear. METHODS: We conducted a retrospective study at a U.S. university hospital of patients with stage 3 CKD (glomerular filtration rate [GFR] 30-59 mL/min/1.73 m(2)) who had undergone bariatric surgery. The renal function of the included patients was recorded for a 2-year period after surgery to analyze the rate of loss or improvement in renal function. The estimated GFR was calculated using the Modification of Diet in Renal Disease 4-variable formula. Patients who developed acute renal failure in the postoperative period were excluded. RESULTS: A total of 25 patients with stage 3 CKD were included. Their average body mass index at surgery was 49.8 kg/m(2), the mean GFR was 47.9 mL/min/1.73 m(2), and the mean serum creatinine was 1.4 mg/dL. The body mass index had decreased to 38.4 kg/m(2) (paired t test, P < .001) at the end of 6 months and to 34.5 kg/m(2) (P < .001) at the end of 12 months. The mean systolic blood pressure had decreased from 133 +/- 13 to 128 +/- 17 mm Hg at the end of 12 months. The mean GFR at 6 months of follow-up had improved to 56.6 mL/min/1.73 m(2) (P < .001) and to 61.6 mL/min/1.73 m(2) (P < .001) at 12 months. CONCLUSION: The renal function of patients with CKD might improve after bariatric surgery. Larger and long-term studies are warranted to further analyze the effect of bariatric surgery on proteinuria and hard end-points such as the development of end-stage renal disease. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/19359221/Bariatric_surgery_and_progression_of_chronic_kidney_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(09)00058-6 DB - PRIME DP - Unbound Medicine ER -