Effect of bariatric surgery on CKD risk

Allon N. Friedman, Abdus S. Wahed, Junyao Wang, Anita P. Courcoulas, Gregory Dakin, Marcelo W. Hinojosa, Paul L. Kimmel, James E. Mitchell, Alfons Pomp, Walter J. Pories, Jonathan Purnell, Carel Le Roux, Konstantinos Spaniolas, Kristine J. Steffen, Richard Thirlby, Bruce Wolfe

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Obesity is linked to the development and progression of CKD, but whether bariatric surgery protects against CKD is poorly understood. We, therefore, examined whether bariatric surgery influences CKD risk. The study included 2144 adults who underwent bariatric surgery from March of 2006 to April of 2009 and participated in the Longitudinal Assessment of Bariatric Surgery-2 Study cohort. The primary outcome was CKD risk categories as assessed by the Kidney Disease Improving Global Outcomes (KDIGO) consortium criteria using a combination of eGFR and albuminuria. Patients were 79% women and 87% white, with a median age of 46 years old. Improvements were observed in CKD risk at 1 and 7 years after surgery in patients with moderate baseline CKD risk (63% and 53%, respectively), high baseline risk (78% and 56%, respectively), and very high baseline risk (59% and 23%, respectively). The proportion of patients whose CKD risk worsened was ≤10%; five patients developed ESRD. Sensitivity analyses using year 1 as baseline to minimize the effect of weight loss on serum creatinine and differing eGFR equations offered qualitatively similar results. Treatment with bariatric surgery associated with an improvement in CKD risk categories in a large proportion of patients for up to 7 years, especially in those with moderate and high baseline risk. These findings support consideration of CKD risk in evaluation for bariatric surgery and further study of bariatric surgery as a treatment for high-risk obese patients with CKD.

Original languageEnglish (US)
Pages (from-to)1289-1300
Number of pages12
JournalJournal of the American Society of Nephrology
Volume29
Issue number4
DOIs
StatePublished - Apr 1 2018

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Bariatric Surgery
Albuminuria
Kidney Diseases
Chronic Kidney Failure
Weight Loss
Creatinine
Cohort Studies
Obesity

ASJC Scopus subject areas

  • Nephrology

Cite this

Friedman, A. N., Wahed, A. S., Wang, J., Courcoulas, A. P., Dakin, G., Hinojosa, M. W., ... Wolfe, B. (2018). Effect of bariatric surgery on CKD risk. Journal of the American Society of Nephrology, 29(4), 1289-1300. https://doi.org/10.1681/ASN.2017060707

Effect of bariatric surgery on CKD risk. / Friedman, Allon N.; Wahed, Abdus S.; Wang, Junyao; Courcoulas, Anita P.; Dakin, Gregory; Hinojosa, Marcelo W.; Kimmel, Paul L.; Mitchell, James E.; Pomp, Alfons; Pories, Walter J.; Purnell, Jonathan; Le Roux, Carel; Spaniolas, Konstantinos; Steffen, Kristine J.; Thirlby, Richard; Wolfe, Bruce.

In: Journal of the American Society of Nephrology, Vol. 29, No. 4, 01.04.2018, p. 1289-1300.

Research output: Contribution to journalArticle

Friedman, AN, Wahed, AS, Wang, J, Courcoulas, AP, Dakin, G, Hinojosa, MW, Kimmel, PL, Mitchell, JE, Pomp, A, Pories, WJ, Purnell, J, Le Roux, C, Spaniolas, K, Steffen, KJ, Thirlby, R & Wolfe, B 2018, 'Effect of bariatric surgery on CKD risk', Journal of the American Society of Nephrology, vol. 29, no. 4, pp. 1289-1300. https://doi.org/10.1681/ASN.2017060707
Friedman AN, Wahed AS, Wang J, Courcoulas AP, Dakin G, Hinojosa MW et al. Effect of bariatric surgery on CKD risk. Journal of the American Society of Nephrology. 2018 Apr 1;29(4):1289-1300. https://doi.org/10.1681/ASN.2017060707
Friedman, Allon N. ; Wahed, Abdus S. ; Wang, Junyao ; Courcoulas, Anita P. ; Dakin, Gregory ; Hinojosa, Marcelo W. ; Kimmel, Paul L. ; Mitchell, James E. ; Pomp, Alfons ; Pories, Walter J. ; Purnell, Jonathan ; Le Roux, Carel ; Spaniolas, Konstantinos ; Steffen, Kristine J. ; Thirlby, Richard ; Wolfe, Bruce. / Effect of bariatric surgery on CKD risk. In: Journal of the American Society of Nephrology. 2018 ; Vol. 29, No. 4. pp. 1289-1300.
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