Weight Loss After Bariatric Surgery in Morbidly Obese End-Stage Kidney Disease Patients as Preparation for Kidney Transplantation. Matched Pair Analysis in a High-Volume Bariatric and Transplant Center

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

The number of morbidly obese kidney transplant candidates is growing. They have limited access to kidney transplantation and are at a higher risk of postoperative complications. Bariatric surgery is considered as a safe weight loss method in those patients.

Objectives

Matched pair analysis was designed to analyze the preparatory and postoperative weight loss after bariatric procedures in end-stage kidney disease (ESKD) and non-ESKD morbidly obese patients.

Methods

Twenty patients with ESKD underwent bariatric surgery in our Centre of Excellence for Bariatric and Metabolic Surgery between 2015 and 2019 (nine one-anastomosis gastric bypasses, nine Roux-en-Y gastric bypasses, and two sleeve gastrectomies). They were compared with matched pairs from a dataset of 1199 morbidly obese patients without ESKD. Data on demographic factors and comorbidities was recorded. BMI was obtained at the start of the preparatory period preceding the bariatric procedure, at the time of procedure, and during the 1-year follow-up.

Results

The ESKD and non-ESKD patients did not differ significantly in preoperative weight loss (13.00 ± 11.69 kg and 15.22 ± 15.96 kg respectively, p = 0.619). During the 1-year follow-up, the weight loss was similar to the non-ESKD group. In the first 3 months, faster weight loss in ESKD was observed. Initial and follow-up BMI values did not differ significantly between groups. We demonstrated that obese patients with ESKD can lose weight as effectively as non-ESKD patients.

Conclusion

Morbidly obese ESKD patients have an equal weight loss to patients without ESKD. Bariatric surgery could improve access to kidney transplantation and may potentially improve transplantation outcomes of obese patients with ESKD.

Related collections

Most cited references 30

Record: found
Abstract: not found
Article: not found

Standardized outcomes reporting in metabolic and bariatric surgery.

Maher El Chaar, Pavlos K Papasavas, Julie Kim … (2015)

0 comments Cited 175 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Body mass index and the risk of development of end-stage renal disease in a screened cohort.

Kunitoshi Iseki, K. Kinjo, Shuichi Takishita … (2004)

Obesity is associated with proteinuria and could be a risk factor for end-stage renal disease (ESRD). However, few studies have examined the significance of body mass index (BMI) as a risk factor for the development of ESRD in the general population. We examined the relationship between BMI and the development of ESRD using data from a 1983 community-based screening in Okinawa, Japan. Screenees who developed ESRD by the end of 2000 were identified through the Okinawa Dialysis Study registry. BMI data were available for 100,753 screenees (47,504 men and 53,249 women) aged >/=20 years. The cumulative incidence of ESRD was analyzed according to the quartile of BMI: /=25.5 kg/m(2). The mean (SD) BMI of the screenees was 23.4 (3.3) kg/m(2) (range 7.9 to 59.1 kg/m(2)); the mean was 23.4 kg/m(2) for both men and women. During the follow-up period, 404 screenees (232 men and 172 women) developed ESRD. The cumulative incidences of ESRD per 1000 screenees were, from the lowest to highest BMI quartile, 2.48, 3.79, 3.86, and 5.81. The odds ratio (95% CI) of BMI for developing ESRD, after adjustment for age, sex, systolic blood pressure, and proteinuria, was 1.273 (1.121-1.446, P= 0.0002) for men and 0.950 (0.825-1.094, not significant) for women. We found that BMI was associated with an increased risk of the development of ESRD in men in the general population in Okinawa. The maintenance of optimal body weight may reduce the risk of ESRD.

0 comments Cited 143 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

European Renal Best Practice Guideline on kidney donor and recipient evaluation and perioperative care.

Armando Torres, Paul Harden, Marivonne Hourmant … (2015)

The European Best Practice Guideline group (EBPG) issued guidelines on the evaluation and selection of kidney donor and kidney transplant candidates, as well as post-transplant recipient care, in the year 2000 and 2002. The new European Renal Best Practice board decided in 2009 that these guidelines needed updating. In order to avoid duplication of efforts with kidney disease improving global outcomes, which published in 2009 clinical practice guidelines on the post-transplant care of kidney transplant recipients, we did not address these issues in the present guidelines.The guideline was developed following a rigorous methodological approach: (i) identification of clinical questions, (ii) prioritization of questions, (iii) systematic literature review and critical appraisal of available evidence and (iv) formulation of recommendations and grading according to Grades of Recommendation Assessment, Development, and Evaluation (GRADE). The strength of each recommendation is rated 1 or 2, with 1 being a 'We recommend' statement, and 2 being a 'We suggest' statement. In addition, each statement is assigned an overall grade for the quality of evidence: A (high), B (moderate), C (low) or D (very low). The guideline makes recommendations for the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and perioperative recipient care.All together, the work group issued 112 statements. There were 51 (45%) recommendations graded '1', 18 (16%) were graded '2' and 43 (38%) statements were not graded. There were 0 (0%) recommendations graded '1A', 15 (13%) were '1B', 19 (17%) '1C' and 17 (15%) '1D'. None (0%) were graded '2A', 1 (0.9%) was '2B', 8 (7%) were '2C' and 9 (8%) '2D'. Limitations of the evidence, especially the lack of definitive clinical outcome trials, are discussed and suggestions are provided for future research.We present here the complete recommendations about the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and the perioperative recipient care. We hope that this document will help caregivers to improve the quality of care they deliver to patients. The full version with methods, rationale and references is published in Nephrol Dial Transplant (2013) 28: i1-i71; doi: 10.1093/ndt/gft218 and can be downloaded freely from http://www.oxfordjournals.org/our_journals/ndt/era_edta.html.

0 comments Cited 68 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Małgorzata Dobrzycka: malgorzata.dobrzycka@gumed.edu.pl

Journal

Journal ID (nlm-ta): Obes Surg

Journal ID (iso-abbrev): Obes Surg

Title: Obesity Surgery

Publisher: Springer US (New York )

ISSN (Print): 0960-8923

ISSN (Electronic): 1708-0428

Publication date (Electronic): 5 April 2020

Publication date PMC-release: 5 April 2020

Publication date (Print): 2020

Volume: 30

Issue: 7

Pages: 2708-2714

Affiliations

[1 ]GRID grid.11451.30, ISNI 0000 0001 0531 3426, Department of General, Endocrine and Transplant Surgery, , Medical University of Gdansk, ; Gdansk, Poland

[2 ]GRID grid.11451.30, ISNI 0000 0001 0531 3426, Department of Nephrology and Transplant Medicine, , Medical University of Gdansk, ; Gdansk, Poland

Article

Publisher ID: 4555

DOI: 10.1007/s11695-020-04555-8

PMC ID: 7260258

PubMed ID: 32249367

SO-VID: bf71e39e-afe5-44d3-937a-ddf0fba4184f

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Funding

Funded by: Medical University of Gdansk

Custom metadata

ScienceOpen disciplines: Surgery

Keywords: bariatric surgery,kidney transplantation,end-stage kidney disease,weight loss

Data availability:

ScienceOpen disciplines: Surgery

Keywords: bariatric surgery, kidney transplantation, end-stage kidney disease, weight loss

Weight Loss After Bariatric Surgery in Morbidly Obese End-Stage Kidney Disease Patients as Preparation for Kidney Transplantation. Matched Pair Analysis in a High-Volume Bariatric and Transplant Center

Read this article at

Abstract

Background

Objectives

Methods

Results

Conclusion

Related collections

Karger: Nutrition and Dietetics

Most cited references 30

Standardized outcomes reporting in metabolic and bariatric surgery.

Body mass index and the risk of development of end-stage renal disease in a screened cohort.

European Renal Best Practice Guideline on kidney donor and recipient evaluation and perioperative care.

Author and article information

Contributors

Journal

Affiliations

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 199

Cited by 6

Most referenced authors 422