Clara Lee Ying Ngoh1, Jimmy Bok Yan So2, Ho Yee Tiong3, Asim Shabbir2, Boon Wee Teo4. 1. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 2. Department of General Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 3. Department of Urology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 4. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: mdctbw@nus.edu.sg.
Abstract
BACKGROUND: Current literature reports improvement in kidney function in obese patients after bariatric surgery in non-Asian centers. It is unclear how kidney function is affected by postoperative body composition changes in obese Asian patients. OBJECTIVES: To evaluate kidney function and its relationship to body composition in a multiethnic Asian population after bariatric surgery. SETTING: This study was performed in a university hospital. METHODS: Data of 68 obese patients who were followed for 1 year after surgery were retrieved from our university hospital clinical care database. Body composition was obtained by bioimpedance analysis. Kidney function was calculated as glomerular filtration rate (GFR) using the following formulas: (1) Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) (estimated GFR [eGFR], mL/min/1.73 m(2)); (2) absolute GFR (aGFR, mL/min); and (3) lean weight-adjusted Cockcroft-Gault creatinine clearance (CG-LBW, mL/min). Patients were further examined by 2 subgroups: eGFR<90 and>90 mL/min/1.73 m(2). RESULTS: One year after surgery, body mass index (BMI) declined from 41.9±5.7 to 29.6±4.2 kg/m(2) (P<.001), body surface area (BSA) decreased from 2.15±0.23 to 1.86±0.18 m(2) (P<.001), and fat mass (FM) reduced from 45.8±9.4 to 25.6±10.5 kg (P<.001). There were significant differences in percentage excess weight loss (%EWL) among Chinese, Malays, Indians, and other ethnicities. Similar results were found with percentage fat mass loss (%FML). Changes in aGFR were associated with reductions in FM (P = .010), BSA (P = .049), and %EWL (P<.001). In the eGFR>90 subgroup, eGFR decreased from 143±22 to 122±19 mL/min/1.73 m(2). Conversely, in the eGFR<90 subgroup, eGFR had a trend of improvement from 69 to 79 mL/min/1.73 m(2). CONCLUSION: Changes in eGFR after bariatric surgery in the obese Asian patient are strongly associated with reduction in FM, BSA, and %EWL. More work is required to investigate if certain ethnicities have better postoperative renal profiles.
BACKGROUND: Current literature reports improvement in kidney function in obesepatients after bariatric surgery in non-Asian centers. It is unclear how kidney function is affected by postoperative body composition changes in obese Asian patients. OBJECTIVES: To evaluate kidney function and its relationship to body composition in a multiethnic Asian population after bariatric surgery. SETTING: This study was performed in a university hospital. METHODS: Data of 68 obesepatients who were followed for 1 year after surgery were retrieved from our university hospital clinical care database. Body composition was obtained by bioimpedance analysis. Kidney function was calculated as glomerular filtration rate (GFR) using the following formulas: (1) Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) (estimated GFR [eGFR], mL/min/1.73 m(2)); (2) absolute GFR (aGFR, mL/min); and (3) lean weight-adjusted Cockcroft-Gault creatinine clearance (CG-LBW, mL/min). Patients were further examined by 2 subgroups: eGFR<90 and>90 mL/min/1.73 m(2). RESULTS: One year after surgery, body mass index (BMI) declined from 41.9±5.7 to 29.6±4.2 kg/m(2) (P<.001), body surface area (BSA) decreased from 2.15±0.23 to 1.86±0.18 m(2) (P<.001), and fat mass (FM) reduced from 45.8±9.4 to 25.6±10.5 kg (P<.001). There were significant differences in percentage excess weight loss (%EWL) among Chinese, Malays, Indians, and other ethnicities. Similar results were found with percentage fat mass loss (%FML). Changes in aGFR were associated with reductions in FM (P = .010), BSA (P = .049), and %EWL (P<.001). In the eGFR>90 subgroup, eGFR decreased from 143±22 to 122±19 mL/min/1.73 m(2). Conversely, in the eGFR<90 subgroup, eGFR had a trend of improvement from 69 to 79 mL/min/1.73 m(2). CONCLUSION: Changes in eGFR after bariatric surgery in the obese Asian patient are strongly associated with reduction in FM, BSA, and %EWL. More work is required to investigate if certain ethnicities have better postoperative renal profiles.
Authors: Guowei Kim; Chuen Seng Tan; Kah Wei Tan; Serene P Y Lim; Jimmy B Y So; Asim Shabbir Journal: J Gastrointest Surg Date: 2018-09-05 Impact factor: 3.452
Authors: Gregory Xiang Wen Pek; Clara Lee Ying Ngoh; Boon Wee Teo; Anantharaman Vathsala; Benjamin Yen Seow Goh; Clement Hsiang Rong Yong; Lata Raman; Ho Yee Tiong Journal: World J Urol Date: 2018-11-19 Impact factor: 4.226