Kidney Week

Abstract: SA-PO157

Effect of Bariatric Surgery on Renal Function in Morbidly Obese Patients

Session Information

• Diabetic Kidney Disease: Clinical - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Bhalla, Anil, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Anil Bhalla,

• Gupta, Ashwani, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Ashwani Gupta,

• Shingada, Aakash, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Aakash Shingada,

• Gupta, Anurag, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Anurag Gupta,

• Bhargava, Vinant, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Vinant Bhargava,

• Gaur, Lovy, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Lovy Gaur,

• Joshi, Anant, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Anant Joshi,

• Rana, Devinder S., Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Devinder S. Rana,

Background

Morbid obesity is associated with glomerular hyperfiltration, which favours the occurrence of proteinuria. We studied the effect of bariatric surgery on renal function in morbidly obese patients at 6 months post surgery.

Methods

This was a prospective observational study of 75 patients who underwent laparoscopic sleeve gastrectomy for weight reduction. Baseline pre-surgery BMI was calculated and serum creatinine, HbA1C level, 24 hour urinary protein excretion and creatinine clearance(CrCl) was estimated. Investigations were repeated 6 months post surgery to assess change in the renal parameters.

Results

Mean age was 38.8 years (60% females, 40% males). 51.5% patients were hypertensive & 17.6% had diabetes mellitus. Mean weight before bariatric surgery was 119.93kg with a reduction of 25.60kg (21.34%) at 6 months post surgery (p<0.0001). Mean BMI before surgery was 45.13 kg/m2 with a reduction of 9.79 kg/m2 (21.69%) at 6 months post surgery(p<0.001). Mean serum creatinine before surgery was 0.82 mg/dl with a reduction of 0.08 mg/dl (9.75%) 6 month post surgery (p<0.001). Mean pre-op HbA1c was 6.3% with a reduction of 0.74% (11.7%) at 6 months post surgery (p<0.001). Mean CrCl before surgery was 140.69 ml/min with a reduction of 22.89 ml/min (16.2%) 6 month post surgery (p<0.0001). Mean proteinuria before surgery was 224.82 mg/d with a reduction of 57.98 mg/dl (25.77%) 6 month post surgery (p<0.0001). Mean albuminuria before bariatric surgery was 62.53 mg/day with a reduction of 17.35 mg/day (27.74%) 6 months post surgery (p<0.0001). Sub-group analysis showed that pre-operative CrCl was higher in diabetics (144.50 ml/min vs 139.88 ml/min), but the reduction in creatinine clearance was similar between the two groups (p-0.092). Mean baseline proteinuria was higher in diabetics (331.25 mg/day vs 202.02 mg/day) and reduction in proteinuria at 6 month post op was more in diabetics (128.92 mg/day (38.91%) vs 42.79 mg/day (21.18%), p-0.001).

Conclusion

This study shows that obesity related glomerular hyperfiltration improves significantly after bariatric surgery with significant decline in proteinuria. The improvement in hyperfiltration may prevent the development of overt obesity related glomerulopathy.