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Kidney outcomes after bariatric surgery: a population-based cohort study
Christian Goul Sørensen1, Simon Kok Jensen2, Reimar Wernich Thomsen2
1Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark. christiangoul1995@gmail.com.
BMC Nephrology
|August 14, 2025
Summary
Bariatric surgery increases risks for acute kidney injury (AKI) and kidney stones but lowers long-term risks of chronic kidney disease (CKD) and kidney failure compared to obesity alone.
Area of Science:
- Nephrology
- Bariatric Surgery
- Public Health
Background:
- Obesity is linked to chronic kidney disease (CKD).
- Bariatric surgery may improve obesity-related CKD but could increase risks for acute kidney injury (AKI) and hyperoxaluria.
- Kidney outcomes after bariatric surgery require examination.
Purpose of the Study:
- To investigate kidney outcomes following bariatric surgery.
- To compare risks of AKI, nephrolithiasis, CKD, and kidney failure with replacement therapy (KFRT) after bariatric surgery versus matched controls.
Main Methods:
- Population-based registry study in Denmark (2006-2018).
- Included individuals undergoing Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG).
- Age- and sex-matched 1:5 comparison with individuals with obesity but no bariatric surgery; analyzed risks and used Cox regression.
Main Results:
- 18,827 bariatric surgery patients and 94,135 controls included; median follow-up 8.1 years.
- One-year AKI risk was 2.7%; ten-year risks: nephrolithiasis 3.5%, CKD 0.4%, KFRT 0.2%.
- Bariatric surgery associated with increased adjusted HR for AKI (1.63) and nephrolithiasis (1.73), but decreased HR for CKD (0.41) and KFRT (0.63).
Conclusions:
- Bariatric surgery is linked to higher short-term risks of AKI and nephrolithiasis.
- Long-term risks for CKD and kidney failure are reduced after bariatric surgery compared to matched obese individuals.
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