Bariatric Surgery and Renal Function

Currie, Andrew; Chetwood, Andrew; Ahmed, Ahmed R.

doi:10.1007/s11695-011-0356-7

Cited by 57 publications

(28 citation statements)

References 118 publications

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“…24 In addition, obesity-related insulin resistance can limit renal ammoniagenesis and subsequently cause acidic urine, resulting in higher risk of uric acid stone formation. 25 Bariatric surgery has been shown to be an effective treatment for weight loss. 26 However, different types of bariatric surgery carry individual risk of developing kidney stones as revealed in our meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

The risk of kidney stones following bariatric surgery: a systematic review and meta-analysis

et al. 2016

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Background With rising prevalence of morbid obesity, the number of bariatric surgeries performed each year has been increasing worldwide. The objective of this meta-analysis was to assess the risk of kidney stones following bariatric surgery. Methods A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through July 2015. Only studies reporting relative risks, odd ratios or hazard ratios (HRs) to compare risk of kidney stones in patients who underwent bariatric surgery versus no surgery were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results Four studies (One randomized controlled trial and three cohort studies) with 11,348 patients were included in analysis to assess the risk of kidney stones following bariatric surgery. The pooled RR of kidney stones in patients undergoing bariatric surgery was 1.22 (95% CI, 0.63-2.35). The type of bariatric surgery subgroup analysis demonstrated an increased risk of kidney stones in patients following Roux-en-Y gastric bypass (RYGB) with the pooled RR of 1.73 (95% CI, 1.30-2.30) and a decreased risk of kidney stones in patients following restrictive procedures including laparoscopic banding or sleeve gastrectomy with the pooled RR of 0.37 (95% CI, 0.16-0.85). Conclusions Our meta-analysis demonstrates an association between RYGB and increased risk of kidney stones. Restrictive bariatric surgery, on the other hand, may decrease kidney stone risk. Future study with long-term follow-up data is needed to confirm this potential benefit of restrictive bariatric surgery.

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Section: Discussionmentioning

confidence: 99%

The risk of kidney stones following bariatric surgery: a systematic review and meta-analysis

et al. 2016

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“…In summary, the incidence of allograft oxalate nephropathy is likely to rise, given trends in obesity and bariatric surgery among transplant recipients and those on the waitlist (6,17,18). A high index of suspicion is warranted in bariatric surgery patients with unexplained allograft dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…However, recent data suggest that modern bariatric procedures, such as Roux-en-Y bypass, may also impart a twofold increased risk of nephrolithiasis, while 20-75% may have hyperoxaluria, including 20% with very high urine oxalate levels, also putting them at considerable risk of oxalate nephropathy (Table 2) (2,(5)(6)(7)(8)(9)(10)(11)(12). Purely restrictive bariatric procedures, such as gastric banding, may not increase oxalate excretion, yet more data are needed (Table 2) (13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

“…Morbidly obese patients are increasingly encouraged to consider bariatric surgery in order to meet body mass index thresholds for renal or other solid-organ transplantation. Some recipients have a more remote history of bariatric surgery, and others may undergo surgery after transplantation (6,17,18). Registry data report that the prevalence of obesity among kidney transplant recipients increased from 23% to 33% over the last decade (18).…”

Section: Introductionmentioning

confidence: 99%

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Enteric Oxalate Nephropathy in the Renal Allograft: An Underrecognized Complication of Bariatric Surgery

Troxell

Houghton

Hawkey³

et al. 2013

American Journal of Transplantation

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Enteric hyperoxalosis is a recognized complication of bariatric surgery, with consequent oxalate nephropathy leading to chronic kidney disease and occasionally end-stage renal failure. In patients with prior gastrointestinal bypass surgery, renal allografts are also at risk of oxalate nephropathy. Further, transplant recipients may be exposed to additional causes of hyperoxalosis. We report two cases of renal allograft oxalate nephropathy in patients with remote histories of bariatric surgery. Conservative management led to improvement of graft function in one patient, while the other patient returned to dialysis. Interpretation of serologic, urine and biopsy studies is complicated by oxalate accumulation in chronic renal failure, and heightened excretion in the early posttransplant period. A high index of suspicion and careful clinicopathologic correlation on the part of transplant nephrologists and renal pathologists are required to recognize and treat allograft oxalate nephropathy. As the incidence of obesity and pretransplant bariatric surgery increases in the transplant population, allograft oxalate nephropathy is likely to be an increasing cause of allograft dysfunction.

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“…After surgery, improved obesity-related morbidity and overall mortality have been shown in non-eSrD populations (5,6). Improvement in kidney function after bariatric surgery even in eSrD patients was noted in a literature review by Currie et al (7). In other patients, surgery not only improved metabolic syndrome, but also provided a quick path to acceptance onto the transplant list (8).…”

Section: Editormentioning

confidence: 98%