Impact of Weight Loss on the Severity of Albuminuria in Obese Diabetic Patients Undergoing Laparoscopic Sleeve Gastrectomy and One-Anastomosis Gastric Bypass

Abstract

Aim To examine the effect of weight-loss induced bariatric procedures on albuminuria levels among diabetic patients suffering from obesity. Methods Adults patients who suffer from morbid obesity and type 2 diabetes mellitus (T2DM) were included in a prospective cohort study. Subjects were scheduled to undergo laparoscopic sleeve gastrectomy (LSG) or one-anastomosis gastric bypass (OAGB). The albumin-to-creatinine ratio (ACR) was adopted to assess the degree of albuminuria. Microalbuminuria was determined as a ratio of >2.5–30 mg/mmol and >3.5–30 mg/mmol for males and females, respectively, while macroalbuminuria was diagnosed when the ACR exceeded >30 mg/mmol. Results The mean uACR decreased significantly from 20.95±16.89 to 9.92±12.69mg/mmol in LSG cohort (p <0.001), and from 19.52±16.65 to 9.34±11.77mg/mmol in the OAGB cohort, with no statistically considerable differences between both cohorts at the end of follow-up (p = 0.78). Twelve months after the procedures, the percentages of cases with microalbuminuria decreased significantly to 23.8% and 23.9%, respectively (p < 0.001); likewise, the percentages of cases with macroalbuminuria significantly decreased to 7.9% and 7.5% in the LSG and OAGB groups, respectively (p < 0.001). There were no statistically considerable differences between LSG and OAGB regarding the percentages of patients with micro or macroalbuminuria at the end of follow-up. Besides, there were no significant associations between the degree of weight loss and improvement (p = 0.959) or remission (p = 0.73) of microalbuminuria. Conclusion Bariatric surgery significantly reduced the severity of albuminuria 1-year after the procedure, with no preference for one procedure over the other.

Influence of chronic kidney disease and its severity on the efficacy of semaglutide in type 2 diabetes patients: a multicenter real-world study

“…Within each group, the proportion of patients above or below the cut-off were reported for the time points corresponding to baseline and 6 months: are in line with those described for CKD patients in SUSTAIN trials (22). On the other hand, while an association between UACR and HbA1c evolution was never seen in our cohorts, there was a direct correlation between UACR and body weight, which suggests that weight loss promotes improvement of albuminuria, as previously described (30,31). Bariatric surgery was found to reduce the severity of albuminuria 1 year after the procedure, and authors stated that an improvement in albuminuria should be a marker of the resolution of diabesity-mediated renal injury following any successful weight-loss strategy (30).…”

“…On the other hand, while an association between UACR and HbA1c evolution was never seen in our cohorts, there was a direct correlation between UACR and body weight, which suggests that weight loss promotes improvement of albuminuria, as previously described (30,31). Bariatric surgery was found to reduce the severity of albuminuria 1 year after the procedure, and authors stated that an improvement in albuminuria should be a marker of the resolution of diabesity-mediated renal injury following any successful weight-loss strategy (30). Finally, atherogenic and hepatic steatosis indexes improved in both non-CKD and CKD patients.…”