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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Metabolic Surgery Reduces the Risk of Progression From Chronic Kidney Disease to Kidney Failure

David Romero Funes1, David Gutierrez Blanco1, Camila Ortiz Gómez1

  • 1Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL.

Annals of Surgery
|July 11, 2019
PubMed

Insights

Bariatric surgery may improve kidney health in severely obese patients with chronic kidney disease (CKD). It significantly reduced the risk of kidney failure progression in CKD patients within 2-5 years.

Area of Science:

  • Nephrology
  • Bariatric Surgery
  • Public Health

Background:

  • Chronic kidney disease (CKD) affects a significant portion of the elderly population in North America.
  • Obesity is a major risk factor for CKD progression to kidney failure.

Purpose of the Study:

  • To investigate the impact of bariatric surgery on CKD progression in severely obese individuals.
  • To assess changes in kidney function and injury markers post-bariatric surgery.

Main Methods:

  • Retrospective review of 2924 severely obese patients undergoing bariatric surgery over 16 years.
  • Assessment of estimated glomerular filtration rate and urinary albumin-to-creatinine ratio (uACR) pre- and post-surgery.
  • Utilized the Chronic Kidney Disease Prognosis Consortium (CKD-PC) equation to evaluate progression risk.

Main Results:

  • A subset of 69 patients had complete data for kidney assessment.
  • Significant improvements in uACR observed in moderate and severe CKD-related albuminuria.
  • Reduced risk of progression to kidney failure by 70% at 2 years and 60% at 5 years for CKD stage ≥3 patients.

Conclusions:

  • Bariatric surgery demonstrates potential benefits for kidney health in severely obese patients with CKD.
  • The procedure appears particularly effective in mitigating kidney injury in advanced CKD stages.
  • Significant reductions in the 2- and 5-year risk of progression to kidney failure were noted.
Abstract

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