Bariatric surgery and kidney disease outcomes in severely obese youth

Bjornstad, Petter; Nehus, Edward; Raalte, Daniël H. van

doi:10.1016/j.sempedsurg.2020.150883

Cited by 9 publications

(13 citation statements)

References 108 publications

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“…Studies have pointed the improvement of renal function after bariatric surgery, either with increased glomerular ltration rate in patients with chronic kidney disease, or reduction of hyper ltration in patients with no evidence of kidney disease. In this regard, the present results give support to this evidence, which can summarized in improvement of renal function after bariatric surgery [23][24][25][26][27]35].…”

Section: Discussionsupporting

confidence: 82%

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Does bariatric surgery improves kidney function? A cohort study

Bezerra

Brandt

Borborema

et al. 2021

Preprint

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Background Obesity is a global epidemic that may cause renal dysfunction. Weight loss in the postoperative follow-up of bariatric surgery may improve renal function in these patients. Thus, the purpose of this study was to give insight on the subject using a sensible biomarker (cystatin C). Methods This cohort was performed in the Obesity Department from Campina Grande – Paraiba, Brazil. It was randomly enrolled 35 obese who underwent bariatric surgery (12 bypass and 23 sleeve) with follow-up of at least one year. The ages ranged from 24 and 57 years. Those with thyroid disease and with renal disease, with microalbuminuria ≥ 30mg/dL, were excluded. Serum levels of creatinine and cystatin C were measured, and the glomerular filtration rate (GFR) was estimated using the CKD Epi (chronic kidney disease epidemiology collaboration) cystatin-creatinine equation. The investigation was approved by the Ethics Committee. Results Twenty five women (71.4%) and 10 men (28.5%) were randomly recruited for the research. The most frequent associated morbidities were: sexual dysfunction (n = 17–48.5%); blood hypertension (n = 15–42.8%); type II diabetes (n = 13–37.1%); anxiety (n = 14–40.0%); and depression (n = 12–34.2%). Twenty three (65.7%) patients underwent sleeve technique and 12 (34.2%) bypass surgery. It was observed a significant reduction of BMI in the post-operative follow-up – p < 0.0001. There was a significant improvement of glomerular filtration rates (p = 0.0091). The improvement of renal function was more significant among those who underwent sleeve surgery as compared to bypass (p = 0.0008). Conclusion It was observed improvement of the majority of morbidities after bariatric surgery, as well as renal function, in obese individuals. Despite these results, larger and longer term outcome cohorts are required for better answer of the main purpose of this health issue.

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Section: Discussionsupporting

confidence: 82%

“…In some papers one can observe, after this operative procedure, improvement of glomerular ltration rate (GFR), reduction of hyper ltration and decrease in the micro albuminuria, preventing the onset of CKD and its progression. But in others, the improvement of kidney function is not well clear [23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Does bariatric surgery improves kidney function? A cohort study

Bezerra

Brandt

Borborema

et al. 2021

Preprint

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“…Albuminuria significantly improved after surgery in patients with increased albuminuria at baseline (99) . Long-term cohort studies and randomized clinical trials reported that bariatric surgery prevented the development and progression of CKD and improved weight reduction, blood pressure, and metabolic control (100) .…”

Section: A C C E P T E Dmentioning

confidence: 99%

“…Albuminuria significantly improved after surgery in patients with increased albuminuria at baseline [ 98 ]. Long-term cohort studies and randomized clinical trials reported that bariatric surgery prevented the development and progression of CKD and improved weight reduction, blood pressure, and metabolic control [ 99 ]. Pharmacotherapy can be used as a component of a comprehensive strategy for managing patients with severe obesity and obesity-related comorbidities.…”

Section: Managementmentioning

confidence: 99%

Obesity and chronic kidney disease: prevalence, mechanism, and management

Yim

Yoo

2021

Clin Exp Pediatr

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The prevalence of childhood obesity is increasing worldwide at an alarming rate. While obesity is known to increase a variety of cardiovascular and metabolic diseases, it also acts as a risk factor for the development and progression of chronic kidney disease (CKD).During childhood and adolescence, severe obesity is associated with an increased prevalence and incidence of the early stages of kidney disease. Importantly, children born to obese mothers are also at increased risk of developing obesity and CKD later in life. The potential mechanisms underlying the association between obesity and CKD include hemodynamic factors, metabolic effects, and lipid nephrotoxicity. Weight reduction via increased physical activity, caloric restriction, treatment with angiotensin-converting enzyme inhibitors, and judicious bariatric surgery can be used to control obesity and obesity-related kidney disease.Preventive strategies to halt the obesity epidemic in the healthcare community are needed to reduce the widespread deleterious consequences of obesity including CKD development and progression.

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“…It was reported to improve insulin resistance ( Gumbs et al, 2005 ; Rao et al, 2012 ); however, the mechanism remains unclear. Roux-en-Y gastric bypass surgery can effectively relieve T2DM and related metabolic complications while treating morbid obesity ( Bjornstad et al, 2020 ; Vangoitsenhoven et al, 2020 ). In a long-term follow-up study, it was found that patients with T2DM and impaired glucose tolerance maintained normal blood glucose levels after gastric bypass surgery.…”

Section: Introductionmentioning

confidence: 99%

Protective Effects of Bariatric Surgery on Kidney Functions by Inhibiting Oxidative Stress Responses Through Activating PPARα in Rats With Diabetes

Jiang

Zhou

et al. 2021

Front. Physiol.

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ObjectiveThe aim of this study was to explore the protective effects and the regulatory mechanisms of bariatric surgery on kidney injury in diabetic rats.MethodsWe established a useful type 2 diabetic rat model using high-fat and high-sugar diet feeding following low-dose streptozotocin (STZ) treatment. Sprague–Dawley (SD) rats were randomly divided into the following groups: control (Con) group, diabetic nephropathy (DN) group, and duodenal–jejunal bypass (DJB) surgery group. The food intake and body weight of rats were monitored and the glucose tolerance test (OGTT) test was performed every 2 weeks. The glomerular filtration rate (GFR) and urinary albumin excretion rate (UAFR) were measured to assess renal function. Hematoxylin–eosin (H&E), periodic acid–Schiff (PAS), and Masson staining were used to evaluate renal histopathological changes. TUNEL assay was performed to detect cell apoptosis. The expressions of oxidative stress factors and inflammatory factors in the renal tissues of rats were detected by ELISA. The expressions of PPARα, reactive oxygen species (ROS), and NF-κB were detected by immunofluorescence. For in vitro experiment, HK2 cells cultured with high glucose were treated with PPARα agonist, PPARα antagonist, and adenosine 5′-monophosphate (AMP)-activated protein kinase (AMPK) agonist. The expressions of AMPK/PPARα/NF-κB signaling pathway-related proteins were detected by Western blot.ResultsBariatric surgery improved the glucose tolerance of DN rats. The GFR was decreased, the promotion of urinary albumin excretion rate (UAER) was inhibited, and the renal injury was alleviated. The extracellular matrix fraction was decreased and the renal function was improved. Meanwhile, bariatric surgery activates PPARα, inhibits ROS release, reduces oxidative stress injury, and reduces renal cell apoptosis. In vitro experiment results showed that the AMPK activator could activate PPARα, downregulate NF-κB, and inhibit inflammatory response. The phosphorylation of AMPK was inhibited by PPARα antagonism.ConclusionBariatric surgery can activate PPARα, inhibit oxidative stress injury, and improve glucose metabolism and renal function in DN rats.

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Bariatric surgery and kidney disease outcomes in severely obese youth

Cited by 9 publications

References 108 publications

Does bariatric surgery improves kidney function? A cohort study

Does bariatric surgery improves kidney function? A cohort study

Obesity and chronic kidney disease: prevalence, mechanism, and management

Protective Effects of Bariatric Surgery on Kidney Functions by Inhibiting Oxidative Stress Responses Through Activating PPARα in Rats With Diabetes

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