Effect of Bariatric Surgery on Albuminuria in Non-Diabetic Non-Hypertensive Patients with Severe Obesity: a Short-Term Outcome

Abstract

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.

Reduced Risk of Cardiovascular Diseases after Bariatric Surgery Based on the New PREVENT Equations

“…[5][6][7][8][9][10] In addition, bariatric surgery achieves remission rates ranging from 33% to 90% for diabetes, 43% to 83% for hypertension, 16% to 80% for dyslipidemia at 1-year post-surgery, and 77% to 83% for albuminuria at 6-12 months. [11][12][13][14][15] Regarding the risk of future CVD events, we recently reported a ~34% reduction in 10year atherosclerotic CVD (ASCVD) risk, in line with a 2020 review noting a 19% to 54% relative reduction in 10-year CVD risk one year after bariatric surgery. 9,16 All previous studies used well-known CVD risk models such as the Framingham Risk Score for 10-year CHD risk and the American College of Cardiology/American Heart Association (ACC/AHA) pooled cohort equations for 10-year ASCVD risk.…”

Treat Obesity to Treat Type 2 Diabetes Mellitus

“…The nephroprotective effects of AOMs and SGLT2 inhibitors should be strongly considered in the management of patients with obesity, T2DM and renal failure. As with AOMs, BMS can prevent the decline in renal function by reducing proteinuria and albuminuria while improving glomerular hyperfiltration in patients with obesity and impaired renal function [ 100 , 101 ].…”

Interplay between metabolic dysfunction-associated fatty liver disease and chronic kidney disease: Epidemiology, pathophysiologic mechanisms, and treatment considerations

“…Importantly, the CKD stage improved in 12.9% of the study participants, while the prevalence of albuminuria (UACR > 3.5 mg/mmol) decreased from 24.8% to 1.9% at the 1-year follow-up[ 83 ]. Fathy et al [ 84 ] also noted an astonishing albuminuria remission rate (83%) in 137 non-diabetic, non-hypertensive, severely obese subjects with albuminuria who underwent bariatric surgery. Moreover, in another study, subjects undergoing bariatric surgery had a lesser incidence of kidney disease than the control group (hazard ratio 0.46, 95%CI: 0.22-0.92)[ 85 ].…”