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Relationships Between Metabolic and Bariatric Surgery and Adverse Kidney Outcomes: An Analysis of a Retrospective

Kevin C Maki1,2, Stephanie L Dickinson3, Carol F Kirkpatrick1,4

  • 1Midwest Biomedical Research Addison Illinois USA.

Obesity Science & Practice
|December 30, 2025
PubMed
Abstract

Insights

Metabolic and bariatric surgery (MBS) significantly reduces the risk of adverse kidney outcomes in patients with obesity. This weight loss intervention helps preserve kidney function, even in those with type 2 diabetes.

Area of Science:

  • Nephrology
  • Metabolic Surgery
  • Obesity Medicine

Background:

  • Obesity is a major risk factor for chronic kidney disease (CKD).
  • Metabolic and bariatric surgery (MBS) is an effective intervention for sustained weight loss.
  • MBS may mitigate the risk of kidney disease associated with obesity.

Purpose of the Study:

  • To investigate the association between MBS and adverse kidney outcomes.
  • To compare kidney outcomes in obese patients who underwent MBS versus those who did not.

Main Methods:

  • Retrospective cohort analysis of 4322 patients undergoing MBS and 30,919 non-surgical controls.
  • Assessment of primary kidney composite outcomes, including low estimated glomerular filtration rate (eGFR), significant eGFR decline, or kidney failure-related death.
  • Multivariable Cox regression models, with and without inverse propensity of treatment weighting, were used to analyze data.

Main Results:

  • MBS was linked to a 53% lower incidence of the primary kidney composite outcome in patients with type 2 diabetes (T2D) and a 48% reduction in those without T2D.
  • Patients undergoing MBS experienced 48%-56% lower risks for secondary and tertiary kidney outcomes, irrespective of T2D status.
  • Follow-up averaged 6.1 years, demonstrating sustained benefits of MBS on kidney health.

Conclusions:

  • Metabolic and bariatric surgery is associated with substantially reduced risks of adverse kidney outcomes in individuals with obesity.
  • These findings support the use of MBS as a strategy to preserve kidney function in obese patients, including those with T2D.
Keywords:
bariatric surgerychronic kidney diseasemetabolic surgeryobesitytype 2 diabetes mellitus

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