The Impact of Bariatric Surgery on Renal Function: a Retrospective Analysis of Short-Term Outcomes

被引:6
作者
Zhang, Taotao [1 ,2 ]
Wang, Yong [1 ]
Zhang, Xiangwen [2 ]
Wang, Wendi [3 ]
Zhao, Guohua [2 ]
机构
[1] China Med Univ, Dept Gen Surg, Affiliated Hosp 4, Shenyang 110032, Liaoning, Peoples R China
[2] Dalian Med Univ, Dalian Municipal Cent Hosp, Gastr & Intestinal Dept 2, Dalian 116033, Liaoning, Peoples R China
[3] Dalian Med Univ, Dalian Maternal & Childcare Hlth Hosp, Obstet Ward 4, Dalian 116033, Liaoning, Peoples R China
关键词
Bariatric surgery; Estimated glomerular filtration rate; Urinary microalbumin/creatinine ratio; CHRONIC KIDNEY-DISEASE; Y-GASTRIC BYPASS; EXTREMELY OBESE-PATIENTS; WEIGHT-LOSS; INFLAMMATION; INJURY;
D O I
10.1007/s11695-021-05366-1
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose Obesity and diabetes mellitus are now leading causes of chronic kidney disease. Our study investigated the effects of bariatric surgery on estimated glomerular filtration (eGFR) and urinary microalbumin/creatinine ratio (ACR) in morbidly obese patients. Materials and Methods The clinical materials for patients who underwent bariatric surgery were retrospectively analyzed with a 6-month follow-up period between January 1, 2018, and June 1, 2020. The eGFR (ml/min) was calculated using the Cockcroft-Gault formula equation. The urinary ACR was measured during the follow-up. Body mass index (BMI. kg/m(2)), percent weight loss (%WL), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded during the follow-up. Results Sixty-one patients who underwent bariatric surgery-laparoscopic Roux-en-Y gastric bypass (LRYGB; n = 22) and laparoscopic sleeve gastrectomy (LSG; n = 39)-were included in this study. The eGFR of both groups decreased at the follow-up outpatient visits (p < 0.001), although eGFR did not differ between the two groups. Unexpectedly. the ACR increased in the first month after LSG (p < 0.01) but decreased with a descending trend with no significant difference (p > 0.05) throughout the remaining follow-up period. Interestingly, ACR showed a descending trend with no significant difference during the follow-up in the LRYGB group (p > 0.05). The SBP and DBP decreased after bariatric surgery, with no significant difference between the two groups (p > 0.05). Conclusion Bariatric surgery is associated with improvements in postoperative renal function 6 months following surgery. The different alterations in ACR following LSG and LRYGB procedures demonstrate the underlying mechanism.
引用
收藏
页码:3476 / 3482
页数:7
相关论文
共 40 条
[1]   Comments on 'KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease' [J].
Andrassy, Konrad M. .
KIDNEY INTERNATIONAL, 2013, 84 (03) :622-623
[2]   Obesity-initiated metabolic syndrome and the kidney: A recipe for chronic kidney disease? [J].
Bagby, SP .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2004, 15 (11) :2775-2791
[3]   Renal Function in Type 2 Diabetes Following Gastric Bypass A Prospective Cohort Study in Mildly Obese Insulin-Dependent Patients [J].
Billeter, Adrian T. ;
Kopf, Stefan ;
Zeier, Martin ;
Scheurlen, Katharina ;
Fischer, Lars ;
Schulte, Thilo M. ;
Kenngott, Hannes G. ;
Israel, Barbara ;
Knefeli, Philipp ;
Buechler, Markus W. ;
Nawroth, Peter P. ;
Mueller-Stich, Beat P. .
DEUTSCHES ARZTEBLATT INTERNATIONAL, 2016, 113 (49) :827-+
[4]   CKD Prevalence Varies across the European General Population [J].
Bruck, Katharina ;
Stel, Vianda S. ;
Gambaro, Giovanni ;
HaIlan, Stein ;
Volzke, Henry ;
Arnlov, Johan ;
Kastarinen, Mika ;
Guessous, Idris ;
Vinhas, Jose ;
Stengel, Benedicte ;
Brenner, Hermann ;
Chudek, Jerzy ;
Romundstad, Solfrid ;
Tomson, Charles ;
Otero Gonzalez, Alfonso ;
Bello, Aminu K. ;
Ferrieres, Jean ;
Palmieri, Luigi ;
Browne, Gemma ;
Capuano, Vincenzo ;
Van Biesen, Wim ;
Zoccali, Carmine ;
Gansevoort, Ron ;
Navis, Gerjan ;
Rothenbacher, Dietrich ;
Ferraro, Pietro Manuel ;
Nitsch, Dorothea ;
Wanner, Christoph ;
Jager, Kitty J. ;
Consortium, European C. K. D. Burden .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2016, 27 (07) :2135-2147
[5]   The effects of weight loss on renal function in patients with severe obesity [J].
Chagnac, A ;
Weinstein, T ;
Herman, M ;
Hirsh, J ;
Gafter, U ;
Ori, Y .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2003, 14 (06) :1480-1486
[6]   Obesity and kidney disease: differential effects of obesity on adipose tissue and kidney inflammation and fibrosis [J].
Decleves, Anne-Emilie ;
Sharma, Kumar .
CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION, 2015, 24 (01) :28-36
[7]   The Cockcroft-Gault: A Better Predictor of Renal Function in an Overweight and Obese Diabetic Population [J].
Drion, Iefke ;
Joosten, Hanneke ;
Santing, Liane ;
Logtenberg, Susan J. J. ;
Groenier, Klaas H. ;
Lieyerse, Aloysius G. ;
Kleefstra, Nanne ;
Bilo, Henk J. G. .
OBESITY FACTS, 2011, 4 (05) :393-399
[8]   Effect of bariatric surgery-induced weight loss on renal and systemic inflammation and blood pressure: a 12-month prospective study [J].
Fenske, Wiebke K. ;
Dubb, Sukhpreet ;
Bueter, Marco ;
Seyfried, Florian ;
Patel, Karishma ;
Tam, Frederick W. K. ;
Frankel, Andrew H. ;
le Roux, Carel W. .
SURGERY FOR OBESITY AND RELATED DISEASES, 2013, 9 (04) :559-568
[9]   Predicting the Glomerular Filtration Rate in Bariatric Surgery Patients [J].
Friedman, Allon N. ;
Moe, Sharon ;
Fadel, William F. ;
Inman, Margaret ;
Mattar, Samer G. ;
Shihabi, Zak ;
Quinney, Sara K. .
AMERICAN JOURNAL OF NEPHROLOGY, 2014, 39 (01) :8-15
[10]  
Glassock RJ, 2017, NAT REV NEPHROL, V13, P104, DOI [10.1038/nmeph.2016.163, 10.1038/nrneph.2016.163]