Carla N Holcomb1, Lauren E Goss2, Ammar Almehmi3, Jayleen M Grams2, Britney L Corey2. 1. Section of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, 1922 7th Ave South, KB 217, Birmingham, AL, 35294, USA. cholcomb@uabmc.edu. 2. Section of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, 1922 7th Ave South, KB 217, Birmingham, AL, 35294, USA. 3. Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Abstract
INTRODUCTION: Weight loss after bariatric surgery improves both blood pressure and glycemic control following surgery. The effect of bariatric surgery on renal function is not well characterized. In this study, we sought to quantify the change in renal function over time following surgery. METHODS: We retrospectively reviewed all patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) between 2012 and 2014 at our institution. The glomerular filtration rate (GFR, mL/min) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Body mass index (BMI, kg/m2) and percent weight loss (%WL) were calculated following the surgery. RESULTS: A total of 149 patients who underwent bariatric surgery were included in this study: LRYGB (n = 86 and LSG (n = 63). In LRYGB group, baseline BMI (kg/m2, ±SD) and GFR (mL/min, ±SD) were 48.5 ± 6.8 and 94.7 ± 23.8, respectively. In comparison, BMI and GFR were 49.1 ± 11.9 kg/m2 and 93.1 ± 28.0 mL/min in the LSG group, respectively. Over the follow-up period (19.89 ± 10.93 months), the patients who underwent LRGYB lost a larger percentage of weight as compared to those in the LSG group (29.9 ± 11.7% vs 22.3 ± 10.7%; p = <0.0001). Overall, GFR improved in both LRYGB (101.0 ± 25.8 mL/min) and LSG groups (97.9 ± 25.8 mL/min) and was not significantly different between the two groups. Of patients with a GFR < 90 mL/min prior to weight loss surgery (n = 62), 42% had improvement of their GFR to > 90 mL/min postoperatively (p < 0.001). There was no relationship between weight loss percentage and GFR improvement (p = 0.8703). CONCLUSIONS: Bariatric surgery was associated with improvement in postoperative renal function at almost two years following surgery but was not different for LRYGB versus LSG. The gain in GFR was independent of percentage of weight lost suggesting an alternate mechanism in the improvement of renal function other than weight loss alone.
INTRODUCTION:Weight loss after bariatric surgery improves both blood pressure and glycemic control following surgery. The effect of bariatric surgery on renal function is not well characterized. In this study, we sought to quantify the change in renal function over time following surgery. METHODS: We retrospectively reviewed all patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) between 2012 and 2014 at our institution. The glomerular filtration rate (GFR, mL/min) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Body mass index (BMI, kg/m2) and percent weight loss (%WL) were calculated following the surgery. RESULTS: A total of 149 patients who underwent bariatric surgery were included in this study: LRYGB (n = 86 and LSG (n = 63). In LRYGB group, baseline BMI (kg/m2, ±SD) and GFR (mL/min, ±SD) were 48.5 ± 6.8 and 94.7 ± 23.8, respectively. In comparison, BMI and GFR were 49.1 ± 11.9 kg/m2 and 93.1 ± 28.0 mL/min in the LSG group, respectively. Over the follow-up period (19.89 ± 10.93 months), the patients who underwent LRGYB lost a larger percentage of weight as compared to those in the LSG group (29.9 ± 11.7% vs 22.3 ± 10.7%; p = <0.0001). Overall, GFR improved in both LRYGB (101.0 ± 25.8 mL/min) and LSG groups (97.9 ± 25.8 mL/min) and was not significantly different between the two groups. Of patients with a GFR < 90 mL/min prior to weight loss surgery (n = 62), 42% had improvement of their GFR to > 90 mL/min postoperatively (p < 0.001). There was no relationship between weight loss percentage and GFR improvement (p = 0.8703). CONCLUSIONS: Bariatric surgery was associated with improvement in postoperative renal function at almost two years following surgery but was not different for LRYGB versus LSG. The gain in GFR was independent of percentage of weight lost suggesting an alternate mechanism in the improvement of renal function other than weight loss alone.
Authors: Karl J Neff; Andrew H Frankel; Frederick W K Tam; Denise M Sadlier; Catherine Godson; Carel W le Roux Journal: Nephrol Dial Transplant Date: 2013-09-26 Impact factor: 5.992
Authors: Matthew L Maciejewski; David E Arterburn; Lynn Van Scoyoc; Valerie A Smith; William S Yancy; Hollis J Weidenbacher; Edward H Livingston; Maren K Olsen Journal: JAMA Surg Date: 2016-11-01 Impact factor: 14.766
Authors: Andrew S Levey; Lesley A Stevens; Christopher H Schmid; Yaping Lucy Zhang; Alejandro F Castro; Harold I Feldman; John W Kusek; Paul Eggers; Frederick Van Lente; Tom Greene; Josef Coresh Journal: Ann Intern Med Date: 2009-05-05 Impact factor: 25.391
Authors: Daniela S C Magalhães; Jorge M P Pedro; Pedro E B Souteiro; João Sérgio Neves; Sofia Castro-Oliveira; Rita Bettencourt-Silva; Maria Manuel Costa; Ana Varela; Joana Queirós; Paula Freitas; Davide Carvalho Journal: Obes Surg Date: 2019-01 Impact factor: 4.129
Authors: Kyle H Sheetz; Kenneth J Woodside; Vahakn B Shahinian; Justin B Dimick; John R Montgomery; Seth A Waits Journal: Clin J Am Soc Nephrol Date: 2019-07-25 Impact factor: 8.237
Authors: Ahmed Salman; Mohamed Salman; Mohamed D Sarhan; Karim Maurice; Mohamed Tag El-Din; Ahmed Youssef; Reham Ahmed; Tarek Abouelregal; Hossam El-Din Shaaban; Ghada M K GabAllah; Mahmoud Gouda Omar Journal: Int J Gen Med Date: 2021-03-10