The Effect of Biliopancreatic Diversion Surgery on Renal Function—a Retrospective Study

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• 作者：Biju Jose (1)
  Stephen Ford (2)
  Paul Super (1) (3)
  G. Neil Thomas (4)
  Indranil Dasgupta (2)
  Shahrad Taheri (1) (5)
  
• 关键词：Obesity ; Renal function ; Weight loss ; Bariatric surgery
• 刊名：Obesity Surgery
• 出版年：2013
• 出版时间：May 2013
• 年：2013
• 卷：23
• 期：5
• 页码：634-637
• 全文大小：150KB
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• 作者单位：Biju Jose (1)
  Stephen Ford (2)
  Paul Super (1) (3)
  G. Neil Thomas (4)
  Indranil Dasgupta (2)
  Shahrad Taheri (1) (5)
  
  1. Specialist Weight Management Services, Heart of England Foundation NHS Trust, Birmingham, UK
  2. Department of Renal Medicine, Heart of England Foundation NHS Trust, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK
  3. Department of Bariatric and Upper Gastrointestinal Surgery, Heart of England Foundation NHS Trust, Birmingham, UK
  4. School of Health and Population Sciences, University of Birmingham, Birmingham, UK
  5. School of Clinical and Experimental Medicine, University of Birmingham, and Birmingham and Black Country NIHR CLAHRC, Room 109, Public Health Building, Edgbaston, B15 2TT, Birmingham, UK
  

文摘

Background The prevalences of obesity and chronic kidney disease (CKD) have increased simultaneously. Should a pathophysiological relationship exist between the two conditions, bariatric surgery and associated weight loss could be an important intervention in extremely obese individuals to slow the progression of CKD. Methods We conducted a retrospective analysis of 25 patients who had undergone biliopancreatic diversion (BPD) surgery for extreme obesity (body mass index >40?kg/m2), with mean follow-up of 4?years. We assessed pre- and post-surgery renal function, body weight and blood pressure (BP) obtained from electronic hospital and primary care records. Results There was a significant reduction in mean body weight at 4?years by 50.3?kg (SD--0.65). The creatinine and estimated glomerular filtration rate (eGFR) also improved significantly: serum creatinine reduced by 16.2?μmol/l (SD--9.57) while the eGFR improved by 10.6?ml/min/m2 (SD--5.45). The greatest improvement in eGFR was in the group (n--) with eGFR ?0?ml/min/m2. A subset of patients (n--1) had evaluable BP readings and had a reduction in BP of 17/10?mmHg (SD--3/12). Conclusions This retrospective study demonstrates a clinically significant improvement in renal function following BPD. Several mechanisms including weight loss could account for the positive impact on renal function. The physiology underlying this improvement requires further study.