Effects of Weight Loss after Biliopancreatic Diversion on Metabolism and Cardiovascular Profile

Abstract

BPD was followed by improved cardiovascular profile and a lower pro-inflammatory state. BPD did not produce significant malnutrition, anemia or renal stone disease.

Weight Loss Interventions in Chronic Kidney Disease

“…Effect of nonsurgical interventions on GFR in CKD. 95% CI Ϫ19.59 to Ϫ13.48; P Ͻ 0.001) (26,27,29) with significant heterogeneity noted among the included studies (heterogeneity 2 ϭ 9.04, I 2 ϭ 78%' P ϭ 0.01). Systolic BP.…”

“…Weight loss that was attained through surgical intervention resulted in normalization of GFR (three studies, 77 patients, WMD Ϫ25.56 ml/min; 95% CI Ϫ36.23 to Ϫ14.89; P Ͻ 0.0001) in patients with glomerular hyperfiltration (26,27,29) with no heterogeneity noted among the included studies (heterogeneity 2 ϭ 0.78, I 2 ϭ 0%, P ϭ 0.68; Figure 4). Alexander et al (31) reported nine of 45 patients for whom the renal function remained stable after gastric bypass surgery.…”

“…Systolic BP. Surgical interventions resulted in a significant decrease in SBP at the end of study period (three studies, 104 patients, WMD Ϫ22.63 mmHg; 95% CI Ϫ26.19 to Ϫ19.07; P Ͻ 0.001) (26,27,29) with significant heterogeneity noted among the included trials (heterogeneity 2 ϭ 14.70, I 2 ϭ 86%; P ϭ 0.006).…”

Is there an association between urolithiasis and roux-en-y gastric bypass surgery?

“…This technique involves a common channel of the ileum of 50 to 100 cm, which leads to a great malabsorptive effect, associated with a partial gastrectomy and a remaining a pouch of 200 mL (6). In this study, Palomar et al (4) followed 35 morbidly obese patients and reported a reduction of urinary calcium and citrate associated with increased 24-hours urine oxalate, but they did not report on the incidence of urolithiasis during the study.…”

“…High levels of oxalate salts in urine have also been demonstrated after mixed surgeries for weight loss (those that involve malabsorptive and restrictive components), such as biliopancreatic diversion (4). The mechanism of this disturbance is explained by lipid malabsorption leading to binding between fatty acids that are not absorbed to calcium from the intestinal lumen, leaving free the oxalate that comes from the diet.…”