Background
Obesity is a risk factor for chronic kidney disease and albuminuria. Despite the well-documented obesity association with diabetes mellitus and hypertension, its predisposition to albuminuria is not related to these comorbidities, and, in some times, its occurrence is independent of DM or hypertension.
Purpose of the study
The present study aimed to evaluate bariatric surgery effect on albuminuria in patients with severe obesity with no DM or hypertension.
Materials and methods
The study consisted of 137 patients with extreme obesity and albuminuria scheduled for bariatric surgery and did not have diabetes or hypertension. They underwent an assessment for 24-h urinary albumin at baseline (T0) and 6 months postoperatively (T2).
Results
Albuminuria remission occurred in 83% of patients; there was a statistically highly significant difference between the baseline and the 6-month postoperative in the 24-h urinary albumin assessment. Weight loss and BMI at T2 were independent predictors of albuminuria remission.
Conclusion
The current work emphasizes the importance and promising role of bariatric surgery as an effective weight reduction management method in improving albuminuria, an early sign of chronic kidney disease, and a potential risk factor for cardiovascular disease.
Weight recurrence and gastro-esophageal reflux disease are the most common causes for re-operation after sleeve gastrectomy (SG); Roux-en-Y gastric bypass is the recommended procedure to correct both problems. The V-loc™ (Covidien, Dublin, Ireland) enables faster suturing and less operative time compared to non-barbed sutures. We report an unusual case of early obstruction at the jejunojejunostomy by the tail of V-loc™ suture which grasped surrounding tissue causing adhesions and subsequent obstruction. When reviewing the literature for complications of V-loc™, we found three cases of bowel obstruction caused by the leftover free segment of V-loc™. So, V-loc™ thread can cause small bowel obstruction; therefore, we recommend not leaving an extra length at its free end and keep it to a minimum length possible.
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