Prevalence of chronic kidney disease and end-stage renal disease in a bariatric versus nonbariatric population: a retrospective analysis of the US National Inpatient Sample database

Background: In the past five 5 years our team has studied the effects of bariatric surgery on chronic kidney disease (CKD) at our institution. Objectives: The objective of this study was to assess the impact of bariatric surgery (BaS) on the prevalence and likelihood of CKD and end-stage renal disease (ESRD) nationwide. Setting: Academic hospital, United States. Methods: We conducted a retrospective analysis of the U.S. National Inpatient Sample (NIS) database for the years 2010-2015 and compared. Univariate and multivariable analysis were performed to assess the impact of BaS on the point prevalence and the probability of CKD and ESRD. Similarly, a multivariable logistic regression was conducted to measure the impact of the most important risk factors for CKD exclusively in a severely obese population. Results: Data on 296,041 BaS cases and 2,004,804 severely obese controls was extracted from the NIS database and relative to controls, all baseline CKD risk factors were less common among bariatric surgery cases. Nonetheless, even after adjusting for all CKD risk factors, controls exhibited marked increases in the odds of CKD-stage III (odds ratio [OR] 3.10 [3.05-3.14], P < .0001) and modes increase for ESRD (OR 1.13 [1.09-1.18], P < .0001). Overall, even after adjusting for risk factors we observed that the rate of CKD is significantly higher in the control group, 12% when compared with 5.3% in the bariatric surgery group (P < .0001). Conclusion: In this retrospective, case control study of a large, representative national sample of patients with severe obesity, BaS was found to be associated with significantly reduced point-prevalence and likelihood for CKD when adjusted for baseline CKD risk factors as compared with patients with obesity who did not undergo BaS. Overall, BaS resulted in a reduced rate and a moderate decrease in the likelihood of ESRD. (C) 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.