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Risk of nephrolithiasis, hyperoxaluria, and calcium oxalate supersaturation increased after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis.

Abstract

BACKGROUND

Earlier publications have shown renal stone complications after bariatric surgery. Multiple reports have also linked metabolic changes that alter the urinary chemistry profiles, especially hyperoxaluria, after bariatric surgery. However, evidence on change of other urine chemistry studies and type of bariatric surgery and risk of stone has been inconclusive so far.

OBJECTIVES

To explore the association between bariatric surgery and postoperative urinary chemistry change and risk of stone formation SETTING: A systematic review and meta-analysis.

METHODS

We comprehensively searched the databases of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from their dates of inception to January 2016. The inclusion criteria were published studies of association between bariatric surgery and postoperative renal stone formation or urine chemistry profiles. We used random-effects model meta-analysis and calculated the pooled risk of renal stone and difference in 24-hour urine chemistry profiles.

RESULTS

Twelve observational studies were included in the meta-analysis. There was significantly higher risk of stone formation after Roux-en-Y gastric bypass surgery with pooled relative risk = 1.79 (95% CI: 1.54-2.10). In the analysis of urine chemistry profiles, there was significantly higher calcium oxalate supersaturation, lower citrate, and lower volume postoperatively compared with preoperatively. There was also higher urine oxalate in patients who had bariatric surgery compared with nonsurgery controls.

CONCLUSIONS

Roux-en-Y gastric bypass surgery is associated with higher risk of renal stone and increased urine oxalate and calcium oxalate supersaturation.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

    ,

    Department of Internal Medicine, University of Hawaii, Honolulu, Hawaii; Department of Internal Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

    Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address: anawin.sanguankeo@bassett.org.

    Source

    MeSH

    Calcium Oxalate
    Controlled Clinical Trials as Topic
    Female
    Gastric Bypass
    Humans
    Hyperoxaluria
    Kidney Calculi
    Male
    Obesity
    Observational Studies as Topic
    Postoperative Complications
    Risk Factors

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    27396545

    Citation

    Upala, Sikarin, et al. "Risk of Nephrolithiasis, Hyperoxaluria, and Calcium Oxalate Supersaturation Increased After Roux-en-Y Gastric Bypass Surgery: a Systematic Review and Meta-analysis." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 12, no. 8, 2016, pp. 1513-1521.
    Upala S, Jaruvongvanich V, Sanguankeo A. Risk of nephrolithiasis, hyperoxaluria, and calcium oxalate supersaturation increased after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. Surg Obes Relat Dis. 2016;12(8):1513-1521.
    Upala, S., Jaruvongvanich, V., & Sanguankeo, A. (2016). Risk of nephrolithiasis, hyperoxaluria, and calcium oxalate supersaturation increased after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 12(8), pp. 1513-1521. doi:10.1016/j.soard.2016.04.004.
    Upala S, Jaruvongvanich V, Sanguankeo A. Risk of Nephrolithiasis, Hyperoxaluria, and Calcium Oxalate Supersaturation Increased After Roux-en-Y Gastric Bypass Surgery: a Systematic Review and Meta-analysis. Surg Obes Relat Dis. 2016;12(8):1513-1521. PubMed PMID: 27396545.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk of nephrolithiasis, hyperoxaluria, and calcium oxalate supersaturation increased after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. AU - Upala,Sikarin, AU - Jaruvongvanich,Veeravich, AU - Sanguankeo,Anawin, Y1 - 2016/04/06/ PY - 2016/02/22/received PY - 2016/03/29/revised PY - 2016/04/04/accepted PY - 2016/7/12/pubmed PY - 2017/11/1/medline PY - 2016/7/12/entrez KW - Bariatric surgery KW - Calcium oxalate KW - Nephrolithiasis KW - Renal stone KW - Urine chemistry SP - 1513 EP - 1521 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 12 IS - 8 N2 - BACKGROUND: Earlier publications have shown renal stone complications after bariatric surgery. Multiple reports have also linked metabolic changes that alter the urinary chemistry profiles, especially hyperoxaluria, after bariatric surgery. However, evidence on change of other urine chemistry studies and type of bariatric surgery and risk of stone has been inconclusive so far. OBJECTIVES: To explore the association between bariatric surgery and postoperative urinary chemistry change and risk of stone formation SETTING: A systematic review and meta-analysis. METHODS: We comprehensively searched the databases of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from their dates of inception to January 2016. The inclusion criteria were published studies of association between bariatric surgery and postoperative renal stone formation or urine chemistry profiles. We used random-effects model meta-analysis and calculated the pooled risk of renal stone and difference in 24-hour urine chemistry profiles. RESULTS: Twelve observational studies were included in the meta-analysis. There was significantly higher risk of stone formation after Roux-en-Y gastric bypass surgery with pooled relative risk = 1.79 (95% CI: 1.54-2.10). In the analysis of urine chemistry profiles, there was significantly higher calcium oxalate supersaturation, lower citrate, and lower volume postoperatively compared with preoperatively. There was also higher urine oxalate in patients who had bariatric surgery compared with nonsurgery controls. CONCLUSIONS: Roux-en-Y gastric bypass surgery is associated with higher risk of renal stone and increased urine oxalate and calcium oxalate supersaturation. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/27396545/Risk_of_nephrolithiasis_hyperoxaluria_and_calcium_oxalate_supersaturation_increased_after_Roux_en_Y_gastric_bypass_surgery:_a_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(16)30035-1 DB - PRIME DP - Unbound Medicine ER -