2009-P: Improvement in Renal Function Associated with Endobarrier (EB)–Induced Weight Loss

Abstract

EB, a 60 cm proximal intestinal liner, endoscopically-implanted for up to 1 year, reduces weight and HbA1c. As the risk of progressive kidney-disease is increased by high BMI, we assessed the impact of EB on renal function. In 89 consecutive patients (aged 51.2 ± 8.0 years, 48.3% male, 55.1% europid, diabetes duration 10.8 (7.0-16.7) years, BMI 41.3 ± 6.9 kg/m2), mean ± SD HbA1c fell by 1.9 ± 1.8 %, from 9.4 ± 1.9 to 7.5 ± 1.2 % (p<0.001), weight fell by 15.0 ± 8.3 kg from 119.1 ± 26.3 to 104.1 ± 27.0 kg (p<0.001), systolic blood pressure (BP) from 138.4 ± 15.5 to 126.3 ± 16.9 mmHg (p<0.001) (Table 1a). With regard to renal function, mean ± SD serum creatinine improved by 5.0 ± 15.5 μmol/L from 88.9 ± 41.8 to 83.9 ± 42.1 μmol/L (p=0.003) and estimated-Glomerular-Filtration-Rate (eGFR - abbreviated MDRD equation) improved by 6.5 ±10.7 ml/min/1.73m2 from 83.6 ± 23.4 to 90.1 ± 25.7 ml/min/1.73m2 (p<0.001) (Table 1b). Eight patients had raised serum creatinine (>133μmol/L) prior to EB; after implantation in 6 of these, creatinine reduced and in 3 creatinine normalised. It was noteworthy, that the 6 patients with renal impairment who sustained improvement had large weight loss (mean 17.3 kg), whereas the patients without improvement had lower weight loss (mean 6 kg). As well as previously documented improvements, in weight, HbA1c and BP, EB was associated with improvements in renal function. These observational findings warrant further investigation. Disclosure R.E.J. Ryder: Consultant; Self; GI Dynamics Inc. Other Relationship; Self; Novo Nordisk A/S. M. Yadagiri: None. S.P. Irwin: None. W. Burbridge: None. R. Allden: None. T. Bashir: None. J. Bleasdale: None. E. Fogden: None. M. Anderson: None. P. Sen Gupta: None. P. Cockwell: Speaker’s Bureau; Self; Napp Pharmaceuticals.