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Bariatric Surgery Improves Renal Function: a Large Inner-City Population Outcome Study

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Abstract

Background

Bariatric surgery is associated with improved renal dysfunction in general population studies. The study examined the effects of bariatric surgery on renal function in a predominantly Hispanic and African American population at a community hospital in New York, USA.

Methods

This retrospective study analyzed prospectively collected bariatric surgical data from 2247 patients (89% female) who underwent bariatric surgery at a single center. Changes in glomerular filtration rate (eGFR), urine albumin–creatinine ratio (UACR), micro- and macroalbuminuria, and hyperfiltration, which were measured preoperatively and then yearly for 3 years postoperatively, were evaluated with t tests and logistic regression analysis, after adjusting for confounding variables. The mean age of the patients at surgery was 37.1 years; the mean preoperative body mass index was 45 ± 7 kg/m2.

Results

The results obtained 3 years postoperatively showed the following significant improvements compared with the preoperative values: mean UACR decreased from 40.3 to 11.1 mg/g, mean eGFR improved from 79.4 to 87.3 mL/min, the prevalence of microalbuminuria decreased from 13.7 to 6.2%, the prevalence of macroalbuminuria decreased from 2.5 to 0%, and the prevalence of hyperfiltration decreased from 4.4 to 2.7% (all P < .0001). In adjusted multivariate regression analysis, these results remained significant after adjusting for age, sex, race, type of surgery, and presence of diabetes mellitus or hypertension.

Conclusion

In this large study at an inner-city hospital, bariatric surgery was associated with significant improvements in renal dysfunction parameters. These results could assist with informed decisions regarding indications for bariatric surgery.

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Abbreviations

BMI:

Body mass index

CKD:

Chronic kidney disease

eGFR:

Estimated glomerular filtration rate

UACR:

Urine albumin–creatinine ratio

LRYGB:

Laparoscopic Roux-en-Y gastric bypass

SG:

Laparoscopic sleeve gastrectomy

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Authors and Affiliations

  1. Department of Surgery, Cleveland Clinic Florida, Weston, FL, USA

    Kashif Saeed

  2. Department of Surgery, Harlem Hospital Center, New York, NY, USA

    Leaque Ahmed & Sara Alothman

  3. Department of Surgery, Wyckoff Heights Medical Center, Brooklyn, NY, USA

    Leaque Ahmed, Paritosh Suman, Khuram Khan, Hector DePaz, Amrita Persaud & Bianca Passos Fox

  4. Department of Surgery, Osceola Regional Medical Center, Kissimmee, FL, USA

    Sanjiv Gray

  5. Department of Surgery, Montefiore Medical Center, 111 E 210th St, Bronx, NY, 10467, USA

    Saqib Saeed

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  1. Kashif Saeed
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  2. Leaque Ahmed
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  5. Khuram Khan
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Correspondence to Saqib Saeed.

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The authors declare that they have no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Saeed, K., Ahmed, L., Suman, P. et al. Bariatric Surgery Improves Renal Function: a Large Inner-City Population Outcome Study. OBES SURG 31, 260–266 (2021). https://doi.org/10.1007/s11695-020-04909-2

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  • DOI: https://doi.org/10.1007/s11695-020-04909-2

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