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Renal function

Bariatric surgery could improve renal function

(credit: Lee Health, vimeo)
Bariatric surgery could prevent further decline in renal function by reducing proteinuria, albuminuria and improving glomerular hyperfiltration in obese patients with impaired renal function

Bariatric surgery could prevent further decline in renal function by reducing proteinuria, albuminuria and improving glomerular hyperfiltration in obese patients with impaired renal function, according to a meta-analysis by researchers from Huadong Hospital Affiliated to Fudan University and Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China.

In the study, ‘Effects of Bariatric Surgery on Renal Function in Obese Patients: A Systematic Review and Meta Analysis’, published in PlosOne, the researchers assessed whether there is improvement in glomerular filtration rate (GFR), proteinuria or albuminuria after bariatric surgery.

They comprehensively searched the databases of MEDLINE, Embase, web of science and Cochrane for randomized, controlled trials and observational studies that examined bariatric surgery in obese subjects with impaired kidney function. In total, 30 studies were included in the meta-analysis.

The investigators reported that there was a statistically significant reduction in hyperfiltration after bariatric surgery (p=0.008). Meta-analysis showed statistically significant decrease in measured glomerular filtration rate (mGFR), estimated glomerular filtration rate (eGFR), creatinine clearance (CrCl) and eGFR with and without adjustment for body surface area (BSA) after bariatric surgery (p<0.0001).

There was also statistically significant reduction in the incidence of albuminuria and proteinuria after bariatric surgery (p<0.0001). In addition, the meta-analysis showed statistically significant decrease in ACR and 24-h albuminuria after bariatric surgery (p=0.0007). Furthermore, there was a statistically significant decrease in proteinuria after bariatric surgery (p=0.04).

“Bariatric surgery could prevent further decline in renal function by reducing proteinuria, albuminuria and improving glomerular hyperfiltration in obese patients with impaired renal function,” the researchers conclude. “However, whether bariatric surgery reverses chronic kidney disease or delays end stage renal disease progression is still in question, large, randomised prospective studies with a longer follow-up are needed.”

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