The Effect of Bariatric Surgery on Patients with Chronic Kidney Disease

Prasad, Pallavi; Khullar, Dinesh; Grover, Rahul; Chhabra, Gagandeep; Gupta, Nimish; Sinha, Aparna; Sharma, Anil; Ahluwalia, Vikas; Chowbey, Pradeep

doi:10.1007/s11695-020-04812-w

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…Most studies have had a short follow‐up duration and have not differentiated participants with and without T2DM. The key studies assessing the impact of BS on microvascular complications are summarized in Table 2 31–59 and Table 3 22,59–78,81 …”

Section: Effect Of Bs On Microvascular Complicationsmentioning

confidence: 99%

Microvascular complications of obesity and diabetes—Role of bariatric surgery

et al. 2023

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SummaryBariatric surgery in people with obesity can lead to long‐term remission of type 2 diabetes mellitus (T2DM) and a reduction in the incidence of macrovascular complications. The impact of bariatric surgery on microvascular complications is less clear. In this narrative review, we sought to evaluate the effect of bariatric surgery on microvascular complications in patients with and without diabetes. The risk of developing microvascular complications is increased in people with obesity, and this is amplified in those with T2DM. The impact of metabolic surgery on microvascular complications is limited to a subgroup analysis of studies or statistical modeling to predict the glycemia‐independent effect of bariatric surgery. While bariatric surgery halts the progression of retinopathy in those with minimal retinopathy, it may worsen in those with advanced retinopathy. Bariatric surgery improves proteinuria and major renal outcomes, regardless of the severity of renal impairment. Bariatric surgery in patients with obesity with or without diabetes is associated with an improvement in neuropathic symptoms and regeneration of small nerve fibers. In conclusion, bariatric surgery is associated with an improvement in microvascular complications. Further studies are needed to elucidate the underlying mechanisms for the favorable effect of bariatric surgery on microvascular outcomes.

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Section: Effect Of Bs On Microvascular Complicationsmentioning

confidence: 99%

Microvascular complications of obesity and diabetes—Role of bariatric surgery

et al. 2023

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“…Bariatric surgeries are an option for morbidly obese patients who cannot lose weight and are refractory to anti-obesity medications. Bariatric surgery reduces systemic inflammation, proteinuria, and glomerular hyperfiltration in obese CKD patients ( 14 , 15 ). Bariatric surgery also decreases the 5-year risk of mortality by 79% in obese pre-dialysis CKD patients ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Obesity-related kidney disease: Beyond hypertension and insulin-resistance

et al. 2023

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Chronic kidney disease (CKD) causes considerable morbidity, mortality, and health expenditures worldwide. Obesity is a significant risk factor for CKD development, partially explained by the high prevalence of diabetes mellitus and hypertension in obese patients. However, adipocytes also possess potent endocrine functions, secreting a myriad of cytokines and adipokines that contribute to insulin resistance and induce a chronic low-grade inflammatory state thereby damaging the kidney. CKD development itself is associated with various metabolic alterations that exacerbate adipose tissue dysfunction and insulin resistance. This adipose-renal axis is a major focus of current research, given the rising incidence of CKD and obesity. Cellular senescence is a biologic hallmark of aging, and age is another significant risk factor for obesity and CKD. An elevated senescent cell burden in adipose tissue predicts renal dysfunction in animal models, and senotherapies may alleviate these phenotypes. In this review, we discuss the direct mechanisms by which adipose tissue contributes to CKD development, emphasizing the potential clinical importance of such pathways in augmenting the care of CKD.

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“…There are several other benefits for diabetic patients after RYGB including decreased diabetes medication usage, increased insulin secretion, elevated insulin sensitivity, and significant reduction in diabetes-related comorbidities [16]. In some studies, obese individuals who undergo bariatric surgery are associated with improvement of glomerular filtration rate (GFR) and renal function, exclusively in patients with underlying kidney diseases regardless of weight loss alone [7,17]. Amid highly obese individuals, bariatric surgery can result in a significant (92%) reduction in total morbidity and diabetesrelated mortality [18,19].…”

Section: Introductionmentioning

confidence: 99%