The Relationship Between Preoperative Kidney Function and Weight Loss After Bariatric Surgery in Patients with Estimated Glomerular Filtration Rate???30 mL/min: Tehran Obesity Treatment Study

Maryam Barzin | Pouria Mousapour | Maryam Mahdavi | Majid Valizadeh | Farhad Hosseinpanah | Alireza Khlaj

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URL :   http://research.shahed.ac.ir/WSR/WebPages/Report/PaperView.aspx?PaperID=137922
Date :  2020/01/18
Publish in :    Obesity Surgery: The Journal of Metabolic Surgery and Allied Care
DOI :  https://doi.org/10.1007/s11695-020-04407-5
Link :  http://dx.doi.org/10.1007/s11695-020-04407-5
Keywords : Bariatricsurgery .Kidneyfunction .Glomerularfiltrationrate .Weightloss

Abstract :

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Introduction Severeobesitycanleadtoprogressivekidneyinjuryandchronickidneydisease(CKD).Thecurrentstudyaimedat determiningwhetherpreoperativekidneyfunctionlevelinpatientswithestimatedglomerularfiltrationrate(eGFR)≥30mL/min affects weight loss after bariatric surgery. Methods A total of 1958 bariatric patients underwent laparoscopic sleeve gastrectomy and gastric bypass from March 2013 to March 2017. The patients were categorized according to preoperative eGFR (30–59, 60–89, 90–124, and ≥125 mL/min). Changes in body mass index (BMI), percentage of total weight loss (TWL), and percentage of excess weight loss (EWL) were compared across the eGFR categories. Moreover, multivariable logistic regression analysis was used to evaluate the relationship between eGFR and insufficient weight loss (defined as not achieving 50 EWL at 12 months after surgery). Results Preoperative eGFR was positively associated with unadjusted ΔBMI (P trend 0.001), TWL (P trend 0.001), and EWL (P trend=0.007) after 12 months of surgery. However, these associations were no longer significant after multivariable adjustment.Further,univariateanalysisdemonstratedapositiverelationshipbetweenpreoperativeeGFRandinsufficientweight loss (odds ratio OR 1.38; 95 confidence interval CI 1.11–1.71; P=0.004). By contrast, preoperative eGFR was not a predictor of insufficient weight loss in multivariable logistic regression analysis (OR 0.98; 95 CI 0.46–1.24; P=0.886). Conclusion Although patients with lower preoperative eGFR experience less weight loss after bariatric surgery, preoperative kidneyfunctiondoesnotappeartohaveanindependentimpactonpostoperativeweightlossinpatientswitheGFR≥30mL/min