Delphine Sanchez1, Amandine Lebrun1,2, Sosthene Somda1,3, Panagiotis Lainas3,4, Karima Lamouri1, Sophie Prevot2,3,5, Micheline Njike-Nakseu1, Hadrien Tranchart3,4, Martin Gaillard3,4, Mohamad Zaidan3,6, Axel Balian1,2, Ibrahim Dagher3,4, Sylvie Naveau1,2,3, Gabriel Perlemuter1,2,3, Cosmin Sebastian Voican7,8,9. 1. Service d'Hépato-Gastroentérologie Et Nutrition, Hôpital Antoine-Béclère, AP-HP Université Paris-Saclay, Clamart, France. 2. INSERM U996, FHU Hepatinov, Labex LERMIT, Clamart, France. 3. Faculté de Médecine Paris-Saclay, Université Paris-Saclay, Le Kremlin-Bicêtre, France. 4. Service de Chirurgie Digestive Minimale Invasive, Hôpital Antoine-Béclère, AP-HP Université Paris-Saclay, Clamart, France. 5. Service d'Anatomie Pathologique, Hôpital Antoine-Béclère, AP-HP Université Paris-Saclay, Clamart, France. 6. Service Néphrologie-Dialyse-Transplantation, Hôpital Bicêtre, AP-HP Université Paris-Saclay, Le Kremlin-Bicêtre, France. 7. Service d'Hépato-Gastroentérologie Et Nutrition, Hôpital Antoine-Béclère, AP-HP Université Paris-Saclay, Clamart, France. cosmin.voican@aphp.fr. 8. INSERM U996, FHU Hepatinov, Labex LERMIT, Clamart, France. cosmin.voican@aphp.fr. 9. Faculté de Médecine Paris-Saclay, Université Paris-Saclay, Le Kremlin-Bicêtre, France. cosmin.voican@aphp.fr.
Abstract
PURPOSE: Obesity is an independent risk factor for renal injury. A more favorable metabolic environment following weight loss may theoretically lead to improved renal function. We aimed to evaluate the evolution of renal function one year after sleeve gastrectomy in a large prospective cohort of patients with morbid obesity and assess the influence of fat-free mass (FFM) changes. METHODS: We prospectively included obese patients admitted for sleeve gastrectomy between February 2014 and November 2016. We also included a historical observational cohort of patients undergoing sleeve gastrectomy between January 2013 and January 2014 who had FFM evaluation. Patients were systematically evaluated 1 year after surgery. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The FFM was estimated by analyzing computerized tomography (CT) scan sections from CT systematically performed 2 days and 1 year after sleeve gastrectomy to detect surgery complications. RESULTS: Five hundred sixty-three patients fulfilled the inclusion criteria. The mean age was 41.2 ± 0.5 years. The mean body mass index was 43.5 ± 0.3 kg/m2 and 20.4, 30.5, and 30.7% of the included patients had type 2 diabetes, hypertension, and dyslipidemia, respectively. One hundred fifteen patients were excluded and four hundred forty-eight patients were finally included in the analysis. The eGFR was significantly higher 1 year after sleeve gastrectomy than before surgery (87.8 ± 0.9 versus 86.1 ± 0.9, p < 0.01). There was no difference in terms of post-surgery FFM loss between patients with an improved eGFR and those without (6.7 ± 0.3 kg versus 6.8 ± 0.5 kg, p = 0.9). Furthermore, post-surgery changes in the eGFR did not correlate with the amount of FFM loss (r = 0.1, p = 0.18). CONCLUSION: Renal function assessed by eGFR is significantly improved at 1-year post-sleeve gastrectomy, independent of changes in skeletal muscle mass.
PURPOSE: Obesity is an independent risk factor for renal injury. A more favorable metabolic environment following weight loss may theoretically lead to improved renal function. We aimed to evaluate the evolution of renal function one year after sleeve gastrectomy in a large prospective cohort of patients with morbid obesity and assess the influence of fat-free mass (FFM) changes. METHODS: We prospectively included obese patients admitted for sleeve gastrectomy between February 2014 and November 2016. We also included a historical observational cohort of patients undergoing sleeve gastrectomy between January 2013 and January 2014 who had FFM evaluation. Patients were systematically evaluated 1 year after surgery. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The FFM was estimated by analyzing computerized tomography (CT) scan sections from CT systematically performed 2 days and 1 year after sleeve gastrectomy to detect surgery complications. RESULTS: Five hundred sixty-three patients fulfilled the inclusion criteria. The mean age was 41.2 ± 0.5 years. The mean body mass index was 43.5 ± 0.3 kg/m2 and 20.4, 30.5, and 30.7% of the included patients had type 2 diabetes, hypertension, and dyslipidemia, respectively. One hundred fifteen patients were excluded and four hundred forty-eight patients were finally included in the analysis. The eGFR was significantly higher 1 year after sleeve gastrectomy than before surgery (87.8 ± 0.9 versus 86.1 ± 0.9, p < 0.01). There was no difference in terms of post-surgery FFM loss between patients with an improved eGFR and those without (6.7 ± 0.3 kg versus 6.8 ± 0.5 kg, p = 0.9). Furthermore, post-surgery changes in the eGFR did not correlate with the amount of FFM loss (r = 0.1, p = 0.18). CONCLUSION: Renal function assessed by eGFR is significantly improved at 1-year post-sleeve gastrectomy, independent of changes in skeletal muscle mass.
Authors: Wiebke K Fenske; Sukhpreet Dubb; Marco Bueter; Florian Seyfried; Karishma Patel; Frederick W K Tam; Andrew H Frankel; Carel W le Roux Journal: Surg Obes Relat Dis Date: 2012-04-10 Impact factor: 4.734
Authors: Cosmin Sebastian Voican; Amandine Lebrun; Sophie Maitre; Panagiotis Lainas; Karima Lamouri; Micheline Njike-Nakseu; Martin Gaillard; Hadrien Tranchart; Axel Balian; Ibrahim Dagher; Gabriel Perlemuter; Sylvie Naveau Journal: PLoS One Date: 2018-05-14 Impact factor: 3.240