Improvement in albuminuria in patients with type 2 diabetes after laparoscopic adjustable gastric banding

Abstract

Purpose: To determine the effects of laparoscopic adjustable gastric banding (LAGB) on albuminuria in patients with obesity, type 2 diabetes mellitus (T2DM) and established diabetic nephropathy. Methods: A retrospective analysis of clinical records from a tertiary diabetes service identified obese patients with T2DM who had micro-or macroalbuminuria prior to LAGB surgery. Clinical data from follow-up appointments including albuminuria were analysed. Results: A total of 23 T2DM patients were included in the final study. Of 7 patients with macroalbuminuria at baseline, 2 reverted to normoalbuminuria, 2 reverted to microalbuminuria and 3 remained with macroalbuminuria on their final recording in the 36-month period of follow-up. Of 16 patients with microalbuminuria, 9 reverted to normoalbuminuria, while 6 remained with microalbuminuria. Conclusion: This study demonstrates significant improvements in albuminuria in patients with established diabetic nephropathy following LAGB. These results suggest the potential for LAGB to improve or reverse renal damage in patients with T2DM.

Effect of bariatric surgery on diabetic nephropathy in obese type 2 diabetes patients in a retrospective 2-year study: A local pilot

“…Surgery performed included Sleeve Gastrectomy (SG), Roux-en-Y gastric bypass (RYGB) and Lap-Adjustable Gastric Bypass (LAGB). Our results are similar to earlier retrospective studies on effects of BS on DN, such as Zhang et al’s 15 RYGB, Stephenson et al’s 16 LAGB or Iaconelli et al’s 17 prospective study on bilio-pancreatic diversion (BPD) surgery. All three studies showed improvement of DN post surgery.…”

Weight Loss Interventions and Progression of Diabetic Kidney Disease

“…Stephenson et al [35] studied 3-year outcomes after bariatric surgery in 23 patients with T2DM and baseline albuminuria. Mean weight loss was 17 % over the period.…”

Effects of Bariatric Surgery on Renal Function in Obese Patients: A Systematic Review and Meta Analysis

“…Due to their outcomes could not be combined with other studies, 2 studies [ 41 , 48 ] were excluded from meta-analysis. 14 studies of 1186 patients with dichotomous data [ 21 , 23 , 24 , 26 , 27 , 29 , 32 – 34 , 38 , 42 , 43 , 45 , 51 ] and 10 studies of 930 patients with continuous data [ 24 , 25 , 29 , 33 , 36 , 37 , 46 , 47 , 49 , 50 ] were included in the meta-analysis of albuminuria and proteinuria. There were only 5 studies of 184 patients [ 25 , 26 , 28 , 40 , 44 ] in the review of CKD II.…”