Risks of Bariatric Surgery Among Patients With End-stage Renal Disease

Abstract

This study evaluates the perioperative safety of bariatric surgery in obsese patients with end-stage renal disease.

Figure.. Rates of Perioperative Complications Between Patients With End-stage Renal Disease (ESRD) and Normal Kidney Function

Unadjusted (A) and adjusted (B) rates of perioperative complications between patients with ESRD and normal kidney function. Surgical complications include 1 or more of the following: unplanned reoperation, endoscopic intervention, transfusion, superficial surgical site infection (SSI), leak, sepsis, deep or organ space surgical site infection, or unplanned percutaneous drain placement. Medical complications include 1 or more of the following: unplanned intensive care unit (ICU) stay, pneumonia, new venous thromboembolism (VTE), unplanned intubation, need for cardiopulmonary resuscitation (CPR), myocardial infarction, and stroke. Bands indicate upper 95% confidence interval. ^aVariables included in the multivariable regression analysis: patient age, black race/ethnicity, sex, smoking status, hypertension, diabetes, obstructive sleep apnea, chronic steroid/immunosuppressant use, previous percutaneous cardiac intervention and/or surgery, fully or partially dependent functional status, and surgery type (laparoscopic sleeve gastrectomy or roux-en-Y gastric bypass). Patients with unknown/not reported race/ethnicity were assigned a dummy variable and included in the multivariable linear regression analysis (4.5% of ESRD cohort [n = 56] and 5.4% of normal kidney function cohort [n = 22 678]). ^bNo occurrences of stroke in the ESRD cohort. ^cIndicates P < .05. ^dIndicates P < .001.