Bariatric surgery and progression of chronic kidney disease

Surg Obes Relat Dis. Nov-Dec 2009;5(6):662-5. doi: 10.1016/j.soard.2009.01.006. Epub 2009 Jan 28.

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.

Publication types

  • Comparative Study

MeSH terms

  • Bariatric Surgery*
  • Body Mass Index
  • Creatinine / blood
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / physiopathology
  • Male
  • Middle Aged
  • Obesity / complications*
  • Obesity / surgery
  • Prognosis
  • Retrospective Studies
  • Time Factors

Substances

  • Creatinine