Format

Send to

Choose Destination
Kidney Int Rep. 2017 Mar;2(2):261-270. doi: 10.1016/j.ekir.2017.01.010. Epub 2017 Jan 26.

Bariatric Surgery and Kidney-Related Outcomes.

Author information

1
Kidney Health Research Institute, Geisinger Health System, Danville, Pennsylvania, USA.
2
Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, Pennsylvania, USA.
3
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA.
4
Divison of Nephrology, Johns Hopkins University, Baltimore, Maryland, USA.
5
Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
6
Section of Nephrology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.

Abstract

The prevalence of severe obesity in both the general and the chronic kidney disease (CKD) populations continues to rise, with more than one-fifth of CKD patients in the United States having a body mass index of ≥35 kg/m2. Severe obesity has significant renal consequences, including increased risk of end-stage renal disease (ESRD) and nephrolithiasis. Bariatric surgery represents an effective method for achieving sustained weight loss, and evidence from randomized controlled trials suggests that bariatric surgery is also effective in improving blood pressure, reducing hyperglycemia, and even inducing diabetes remission. There is also observational evidence suggesting that bariatric surgery may diminish the long-term risk of kidney function decline and ESRD. Bariatric surgery appears to be relatively safe in patients with CKD, with postoperative complications only slightly higher than in the general bariatric surgery population. The use of bariatric surgery in patients with CKD might help prevent progression to ESRD or enable selected ESRD patients with severe obesity to become candidates for kidney transplantation. However, there are also renal risks in bariatric surgery, namely, acute kidney injury, nephrolithiasis, and, in rare cases, oxalate nephropathy, particularly in types of surgery involving higher degrees of malabsorption. Although bariatric surgery may improve long-term kidney outcomes, this potential benefit remains unproved and must be balanced with potential adverse events.

KEYWORDS:

bariatric surgery; glomerular filtration rate; kidney; morbid obesity; obesity

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center