Bariatric Surgery Improves Renal Function in Patients With Obesity.

Oaklee L Abernathy,Tiffany E Schwasinger-Schmidt,Bobbie G Paull-Forney,Hayrettin Okut

doi:10.7759/cureus.17458

Oaklee L Abernathy, Tiffany E Schwasinger-Schmidt + Show 2 more

Open Access

https://doi.org/10.7759/cureus.17458

Copy DOI

Abstract

BackgroundObesity affects 93.3 million adults in the United States and is a predisposing factor for the development and progression of chronic kidney disease (CKD). The objective of this study is to examine the association between weight loss and renal function in participants undergoing bariatric surgery following a 12-week multidisciplinary, community-based weight loss program.MethodologyThis is a retrospective chart review of participants who voluntarily enrolled in a 12-week multidisciplinary weight loss program prior to bariatric surgery from 2009 to 2018. The primary outcome was to assess the association between weight loss and renal function in participants undergoing bariatric surgery. Secondary outcomes included changes in hemoglobin A1c, lipids, fasting glucose, and blood pressure.ResultsAmong the 55 participants, baseline glomerular filtration rate (GFR) was 49 mL/min/m2, 80% were female, and the average baseline weight was 131 kg. At one-year post-intervention, 69% of patients improved in the CKD stage, with 45% of the participants improving from stage 3A to stage 2. GFR improved to 15 mL/min/1.73m2 (p = 0.025), and there was a negative correlation (rs = -0.3556) between weight and GFR (p = 0.013). Participants with hyperlipidemia had a 12 mL/min/1.73m2 rise in GFR, while participants without the diagnosis at one year had a 24 mL/min/1.73m2 rise in GFR (p = 0.007).ConclusionsThis study demonstrated improved renal function and reduced progression of CKD following a combined lifestyle and surgical intervention, indicating the importance of a comprehensive approach for the management of the chronic disease.

Highlights

Obesity affects 93.3 million adults in the United States and current projections indicate that nearly half of the population aged 18 and older will be obese within the 10 years [1]
At one-year post-intervention, 69% of patients improved in the chronic kidney disease (CKD) stage, with 45% of the participants improving from stage 3A to stage 2
This study demonstrated improved renal function and reduced progression of CKD following a combined lifestyle and surgical intervention, indicating the importance of a comprehensive approach for the management of the chronic disease

Summary

Introduction

Obesity affects 93.3 million adults in the United States and current projections indicate that nearly half of the population aged 18 and older will be obese within the 10 years [1]. The mechanisms linking obesity with cardiovascular disease have been well established; the direct effects of obesity on the kidney are not fully understood [3]. Given the significant contribution of renal function to vascular regulation and remodeling, the effects of obesity on the kidney may result in disproportionate negative effects on the cardiovascular system, increasing overall morbidity and mortality [4,5]. The renal system causes increased glomerular hyperfiltration to compensate for metabolic demands placed on the body, resulting in glomerulomegaly and focal glomerulosclerosis [6]. Renal hyperfiltration increases the intraglomerular pressure which can result in proteinuria and decreased glomerular filtration rate (GFR), putting patients at risk for progression of CKD and development of endstage renal disease (ESRD) [7-9]. Obesity affects 93.3 million adults in the United States and is a predisposing factor for the development and progression of chronic kidney disease (CKD). The objective of this study is to examine the association between weight loss and renal function in participants undergoing bariatric surgery following a 12-week multidisciplinary, community-based weight loss program

Objectives

Results

Discussion

Conclusion