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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Renal Dysfunction Phenotypes in Patients Undergoing Obesity Surgery.

Pedro R Pereira1,2,3, João Pereira2,3, Patrícia C Braga2,3

  • 1Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), 5000-508 Vila Real, Portugal.

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Summary

Obesity surgery candidates often have kidney dysfunction, including albuminuria and proteinuria, alongside hyperfiltration. Routine pre-operative kidney function assessment is recommended for these patients.

Keywords:
albuminuriafatty kidneyobesityobesity-related glomerulopathyproteinuria

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Area of Science:

  • Nephrology
  • Bariatric Surgery
  • Renal Health

Background:

  • Obesity surgery candidates face elevated kidney injury risks.
  • Pre-operative kidney function assessment is frequently overlooked.
  • Understanding renal dysfunction in this population is crucial for patient safety.

Purpose of the Study:

  • To identify renal dysfunction in individuals seeking bariatric surgery.
  • To investigate the prevalence of proteinuria, albuminuria, and hyperfiltration.
  • To determine factors associated with kidney dysfunction in this cohort.

Main Methods:

  • Study included 192 bariatric surgery candidates (BMI 41.7 ± 5.4 kg/m²).
  • Excluded patients with diabetes, metformin-treated prediabetes, neoplastic, or inflammatory diseases.
  • Assessed creatinine clearance, proteinuria, albuminuria, glycated hemoglobin, and lipid profiles.

Main Results:

  • 51% exhibited creatinine clearance >140 mL/min (hyperfiltration).
  • 22.4% had proteinuria >150 mg/day; 14.6% had albuminuria >30 mg/day.
  • Albuminuria was linked to higher glycated hemoglobin and creatinine clearance; proteinuria was not.

Conclusions:

  • Prediabetes, lipid issues, and hyperuricemia correlate with albuminuria in obesity surgery candidates.
  • Tubulointerstitial injury may precede glomerulopathy in obesity-related kidney disease.
  • Routine screening for albuminuria and proteinuria in these candidates is advised.