The Effect of Bariatric Surgery on Patients with Chronic Kidney Disease
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The Effect of Bariatric Surgery on Patients with Chronic Kidney Disease Pallavi Prasad 1 & Dinesh Khullar 2 & Rahul Grover 2 & Gagandeep Chhabra 2 & Nimish Gupta 3 & Aparna Sinha 4 & Anil Sharma 5 & Vikas Ahluwalia 6 & Pradeep Chowbey 5 Received: 21 April 2020 / Revised: 22 June 2020 / Accepted: 22 June 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The effect of bariatric surgery on renal functions of patients with chronic kidney disease (CKD) is not well characterized. This prospective study included 13 adult patients having chronic kidney disease who underwent bariatric surgery. The primary objective was to examine the change in glomerular filtration rate (GFR) at 6 months post-bariatric surgery. Median GFR (measured by creatinine clearance) did not change significantly (55 ml/min vs 59 ml/min, p = 0.345) although there was a significant decrease in the protein excretion rate (1700 mg/day vs 900 mg/day, p = 0.001) at 6 months. An improvement in the KDIGO CKD risk category was seen in 30.7% patients. In CKD patients undergoing bariatric surgery, renal function improves over the first 6 months with a decrease in proteinuria and a stable GFR. Keywords Bariatric surgery . Chronic kidney disease . Glomerular filtration rate . Obesity . Proteinuria
Introduction Obesity is a fast-growing worldwide epidemic, and its role in various diseases like diabetes, heart disease, and stroke has
been widely studied. It also plays a critical role in the progression of chronic kidney disease. Obesity can cause glomerular hyperfiltration, proteinuria, and an eventual decline in glomerular filtration rate by direct pathophysiological mechanisms. It
* Dinesh Khullar [email protected] Pallavi Prasad [email protected]
Pradeep Chowbey [email protected] 1
Rahul Grover [email protected]
Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, No 1 Ramachandra Nagar, Porur, Chennai 600116, India
2
Gagandeep Chhabra [email protected]
Department of Nephrology, Max Super Speciality Hospital, Press Enclave Road, Saket, New Delhi 110017, India
3
Nimish Gupta [email protected]
Department of Nephrology, Metro Heart Institute with Multispeciality, Faridabad 121002, Haryana, India
4
Department of Minimal Access and Bariatric Surgery Anaesthesiology, Max Super Speciality Hospital, Press Enclave Road, Saket, New Delhi 110017, India
5
Department of Minimal Access, Metabolic and Bariatric Surgery, Max Super Speciality Hospital, Press Enclave Road, Saket, New Delhi 110017, India
6
Department of Bariatric Medicine, Max Super Speciality Hospital, Press Enclave Road, Saket, New Delhi 110017, India
Aparna Sinha [email protected] Anil Sharma [email protected] Vikas Ahluwalia [email protected]
OBES SURG
is also a key risk factor for diabetic kidney disease, which is the most common cause of end-stage renal disease in the world [1]. Weight loss interventions for obesity include dietary
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