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Comparative Effectiveness of Roux-en-Y Gastric Bypass vs. One Anastomosis Gastric Bypass on Kidney Function

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Abstract

Purpose

Obesity and its associated medical problems increase risk of kidney function decline while prior studies suggest that bariatric surgery may improve kidney outcomes. However, little is known about the comparative effectiveness of different types of bariatric surgery on kidney function. In this study, we compare the effects of laparoscopic one anastomosis gastric bypass (LOAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) on kidney function one year after surgery.

Materials and Methods

The patients’ demographic, medical, and surgical data were prospectively collected and retrospectively reviewed. Type 2 diabetes mellitus, hypertension, and dyslipidemia, body mass index (BMI), and kidney function tests were obtained before and one year after surgery. Kidney function was evaluated by estimated glomerular filtration rate (eGFR) and spot urine albumin to creatinine ratio (ACR). Changes in eGFR and ACR were compared between LRYGB vs. LOAGB after adjustment for confounders (age, sex, remission of associated medical problems, preoperative BMI, and percentage of excess BMI loss) using ANCOVA model.

Results

Both surgical techniques significantly decreased the post-surgery presence of diabetes, hypertension, and dyslipidemia (p < 0.001 for all paired comparisons). The eGFR level significantly increased and the ACR level significantly decreased in both groups (p < 0.001 for all paired comparisons before and after adjustment). However, eGFR and ACR mean differences between LRYGB and LOAGB were not significantly different after adjustment for confounding variables (p = 0.9 and 0.4, respectively).

Conclusion

Both LOAGB and LRYGB improved 1-year eGFR and ACR equally independently from weight loss and other confounders.

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Acknowledgments

The authors express their gratitude toward Mr. Amir Salar Moazen Safaei for his kind support through this research.

Author information

Authors and Affiliations

  1. Department of Surgery, Isfahan Minimally Invasive Surgery and Obesity Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohsen Mahmoudieh, Behrouz Keleidari, Pedram Hadipour & Shahab Shahabi

  2. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Erfan Sheikhbahaei & Sina Ramtin

  3. Kidney Health Research Institute, Geisinger Health, Danville, Philadelphia, PA, USA

    Alex R. Chang

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  1. Mohsen Mahmoudieh
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  2. Behrouz Keleidari
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  4. Erfan Sheikhbahaei
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Correspondence to Erfan Sheikhbahaei.

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Ethical Considerations

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with 1964 Helsinki declarations and its later amendments. The study commenced after receiving its approval with the registration number of “IR.MUI.MED.REC.1397.223” from the Institutional Review Board of Isfahan University of Medical Sciences.

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

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All authors declare no potential conflict of interest.

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Mahmoudieh, M., Keleidari, B., Hadipour, P. et al. Comparative Effectiveness of Roux-en-Y Gastric Bypass vs. One Anastomosis Gastric Bypass on Kidney Function. OBES SURG 31, 2464–2470 (2021). https://doi.org/10.1007/s11695-021-05295-z

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