Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: A systematic review and meta‐analysis
ABSTRACT The general management for chronic kidney disease (CKD) includes treating reversible causes, including obesity, which may be both a driver and comorbidity for CKD. Bariatric surgery has been shown to reduce the likelihood of CKD progression and improve kidney function in observational studi...
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| Veröffentlicht in: | Nephrology (Carlton, Vic.) Vic.), 2022-01, Vol.27 (1), p.44-56 |
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| creator | Lee, Yung Anvari, Sama Chu, Megan M. Lovrics, Olivia Khondker, Adree Malhan, Roshan Aditya, Ishan Doumouras, Aristithes G. Walsh, Michael Hong, Dennis |
| description | ABSTRACT
The general management for chronic kidney disease (CKD) includes treating reversible causes, including obesity, which may be both a driver and comorbidity for CKD. Bariatric surgery has been shown to reduce the likelihood of CKD progression and improve kidney function in observational studies. We performed a systematic review and meta‐analysis of patients with at least stage 3 CKD and obesity receiving bariatric surgery. We searched Embase, MEDLINE, CENTRAL and identified eligible studies reporting on kidney function outcomes in included patients before and after bariatric surgery with comparison to a medical intervention control if available. Risk of bias was assessed with the Newcastle‐Ottawa Risk of Bias score. Nineteen studies were included for synthesis. Bariatric surgery showed improved eGFR with a mean difference (MD) of 11.64 (95%CI: 5.84 to 17.45, I2 = 66%) ml/min/1.73m2 and reduced SCr with MD of −0.24 (95%CI −0.21 to −0.39, I2 = 0%) mg/dl after bariatric surgery. There was no significant difference in the relative risk (RR) of having CKD stage 3 after bariatric surgery, with a RR of −1.13 (95%CI: −0.83 to −2.07, I2 = 13%), but there was reduced likelihood of having uACR >30 mg/g or above with a RR of −3.03 (95%CI: −1.44 to −6.40, I2 = 91%). Bariatric surgery may be associated with improved kidney function with the reduction of BMI and may be a safe treatment option for patients with CKD. Future studies with more robust reporting are required to determine the feasibility of bariatric surgery for the treatment of CKD.
SUMMARY AT A GLANCE
Amongst patients with CKD G ≧ 3 and obesity, bariatric surgery improved eGFR and reduced serum creatinine levels. |
| doi_str_mv | 10.1111/nep.13958 |
| format | Article |
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The general management for chronic kidney disease (CKD) includes treating reversible causes, including obesity, which may be both a driver and comorbidity for CKD. Bariatric surgery has been shown to reduce the likelihood of CKD progression and improve kidney function in observational studies. We performed a systematic review and meta‐analysis of patients with at least stage 3 CKD and obesity receiving bariatric surgery. We searched Embase, MEDLINE, CENTRAL and identified eligible studies reporting on kidney function outcomes in included patients before and after bariatric surgery with comparison to a medical intervention control if available. Risk of bias was assessed with the Newcastle‐Ottawa Risk of Bias score. Nineteen studies were included for synthesis. Bariatric surgery showed improved eGFR with a mean difference (MD) of 11.64 (95%CI: 5.84 to 17.45, I2 = 66%) ml/min/1.73m2 and reduced SCr with MD of −0.24 (95%CI −0.21 to −0.39, I2 = 0%) mg/dl after bariatric surgery. There was no significant difference in the relative risk (RR) of having CKD stage 3 after bariatric surgery, with a RR of −1.13 (95%CI: −0.83 to −2.07, I2 = 13%), but there was reduced likelihood of having uACR >30 mg/g or above with a RR of −3.03 (95%CI: −1.44 to −6.40, I2 = 91%). Bariatric surgery may be associated with improved kidney function with the reduction of BMI and may be a safe treatment option for patients with CKD. Future studies with more robust reporting are required to determine the feasibility of bariatric surgery for the treatment of CKD.
SUMMARY AT A GLANCE
Amongst patients with CKD G ≧ 3 and obesity, bariatric surgery improved eGFR and reduced serum creatinine levels.</description><identifier>ISSN: 1320-5358</identifier><identifier>EISSN: 1440-1797</identifier><identifier>DOI: 10.1111/nep.13958</identifier><identifier>PMID: 34375462</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>bariatric surgery ; Bariatric Surgery - methods ; Fish oils ; Gastrointestinal surgery ; Humans ; Kidney diseases ; Kidney Function Tests - methods ; Meta-analysis ; Obesity ; Obesity, Morbid - complications ; Obesity, Morbid - surgery ; Patients ; Postoperative Period ; Recovery of Function ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - physiopathology ; Surgery ; Systematic review</subject><ispartof>Nephrology (Carlton, Vic.), 2022-01, Vol.27 (1), p.44-56</ispartof><rights>2021 Asian Pacific Society of Nephrology</rights><rights>2021 Asian Pacific Society of Nephrology.</rights><rights>2022 Asian Pacific Society of Nephrology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-c2ad7783877597fc1732f63f7acdb6bc1a7324ce74fc72d57dfef7ced31eaa833</citedby><cites>FETCH-LOGICAL-c3888-c2ad7783877597fc1732f63f7acdb6bc1a7324ce74fc72d57dfef7ced31eaa833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fnep.13958$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fnep.13958$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34375462$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Yung</creatorcontrib><creatorcontrib>Anvari, Sama</creatorcontrib><creatorcontrib>Chu, Megan M.</creatorcontrib><creatorcontrib>Lovrics, Olivia</creatorcontrib><creatorcontrib>Khondker, Adree</creatorcontrib><creatorcontrib>Malhan, Roshan</creatorcontrib><creatorcontrib>Aditya, Ishan</creatorcontrib><creatorcontrib>Doumouras, Aristithes G.</creatorcontrib><creatorcontrib>Walsh, Michael</creatorcontrib><creatorcontrib>Hong, Dennis</creatorcontrib><title>Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: A systematic review and meta‐analysis</title><title>Nephrology (Carlton, Vic.)</title><addtitle>Nephrology (Carlton)</addtitle><description>ABSTRACT
The general management for chronic kidney disease (CKD) includes treating reversible causes, including obesity, which may be both a driver and comorbidity for CKD. Bariatric surgery has been shown to reduce the likelihood of CKD progression and improve kidney function in observational studies. We performed a systematic review and meta‐analysis of patients with at least stage 3 CKD and obesity receiving bariatric surgery. We searched Embase, MEDLINE, CENTRAL and identified eligible studies reporting on kidney function outcomes in included patients before and after bariatric surgery with comparison to a medical intervention control if available. Risk of bias was assessed with the Newcastle‐Ottawa Risk of Bias score. Nineteen studies were included for synthesis. Bariatric surgery showed improved eGFR with a mean difference (MD) of 11.64 (95%CI: 5.84 to 17.45, I2 = 66%) ml/min/1.73m2 and reduced SCr with MD of −0.24 (95%CI −0.21 to −0.39, I2 = 0%) mg/dl after bariatric surgery. There was no significant difference in the relative risk (RR) of having CKD stage 3 after bariatric surgery, with a RR of −1.13 (95%CI: −0.83 to −2.07, I2 = 13%), but there was reduced likelihood of having uACR >30 mg/g or above with a RR of −3.03 (95%CI: −1.44 to −6.40, I2 = 91%). Bariatric surgery may be associated with improved kidney function with the reduction of BMI and may be a safe treatment option for patients with CKD. Future studies with more robust reporting are required to determine the feasibility of bariatric surgery for the treatment of CKD.
SUMMARY AT A GLANCE
Amongst patients with CKD G ≧ 3 and obesity, bariatric surgery improved eGFR and reduced serum creatinine levels.</description><subject>bariatric surgery</subject><subject>Bariatric Surgery - methods</subject><subject>Fish oils</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Kidney diseases</subject><subject>Kidney Function Tests - methods</subject><subject>Meta-analysis</subject><subject>Obesity</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - surgery</subject><subject>Patients</subject><subject>Postoperative Period</subject><subject>Recovery of Function</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Surgery</subject><subject>Systematic review</subject><issn>1320-5358</issn><issn>1440-1797</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFu1DAQhi0EoqVw4AWQJS7lkDa249jLrapKqVQBBzhHjj2mLomzeJxd5cYj9NzH65Ngui0HJHwZy_PNp5F_Ql6z-oiVcxxhfcTESuonZJ81TV0xtVJPy13wupJC6j3yAvG6rpniLXtO9kQjlGxavk9uL8Z1mjYwQsx08vRHcBEW6udoc5giDZGuTQ6li3Qb8hW1V2mKwT6CLiAYBGqiowgbSECnHjDkhRqfIdHepGByKhM4p--Qlvf0hOKCGcbitTTBJsD2fn6EbO5-3ZhohgUDviTPvBkQXj3UA_Ltw9nX04_V5efzi9OTy8oKrXVluXFKaaGVkivlLVOC-1Z4Zazr294yUx4aC6rxVnEnlfPglQUnGBijhTgghztv-YifM2DuxoAWhsFEmGbsuGxrvlJS6oK-_Qe9nuZU9i1UyzjTdduwQr3bUTZNiAl8t05hNGnpWN39CawrgXX3gRX2zYNx7kdwf8nHhApwvAO2YYDl_6bu09mXnfI3JsmkPQ</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Lee, Yung</creator><creator>Anvari, Sama</creator><creator>Chu, Megan M.</creator><creator>Lovrics, Olivia</creator><creator>Khondker, Adree</creator><creator>Malhan, Roshan</creator><creator>Aditya, Ishan</creator><creator>Doumouras, Aristithes G.</creator><creator>Walsh, Michael</creator><creator>Hong, Dennis</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>202201</creationdate><title>Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: A systematic review and meta‐analysis</title><author>Lee, Yung ; 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The general management for chronic kidney disease (CKD) includes treating reversible causes, including obesity, which may be both a driver and comorbidity for CKD. Bariatric surgery has been shown to reduce the likelihood of CKD progression and improve kidney function in observational studies. We performed a systematic review and meta‐analysis of patients with at least stage 3 CKD and obesity receiving bariatric surgery. We searched Embase, MEDLINE, CENTRAL and identified eligible studies reporting on kidney function outcomes in included patients before and after bariatric surgery with comparison to a medical intervention control if available. Risk of bias was assessed with the Newcastle‐Ottawa Risk of Bias score. Nineteen studies were included for synthesis. Bariatric surgery showed improved eGFR with a mean difference (MD) of 11.64 (95%CI: 5.84 to 17.45, I2 = 66%) ml/min/1.73m2 and reduced SCr with MD of −0.24 (95%CI −0.21 to −0.39, I2 = 0%) mg/dl after bariatric surgery. There was no significant difference in the relative risk (RR) of having CKD stage 3 after bariatric surgery, with a RR of −1.13 (95%CI: −0.83 to −2.07, I2 = 13%), but there was reduced likelihood of having uACR >30 mg/g or above with a RR of −3.03 (95%CI: −1.44 to −6.40, I2 = 91%). Bariatric surgery may be associated with improved kidney function with the reduction of BMI and may be a safe treatment option for patients with CKD. Future studies with more robust reporting are required to determine the feasibility of bariatric surgery for the treatment of CKD.
SUMMARY AT A GLANCE
Amongst patients with CKD G ≧ 3 and obesity, bariatric surgery improved eGFR and reduced serum creatinine levels.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>34375462</pmid><doi>10.1111/nep.13958</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Nephrology (Carlton, Vic.), 2022-01, Vol.27 (1), p.44-56 |
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| language | eng |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | bariatric surgery Bariatric Surgery - methods Fish oils Gastrointestinal surgery Humans Kidney diseases Kidney Function Tests - methods Meta-analysis Obesity Obesity, Morbid - complications Obesity, Morbid - surgery Patients Postoperative Period Recovery of Function Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - physiopathology Surgery Systematic review |
| title | Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: A systematic review and meta‐analysis |
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