TP5.2.18 Should follow up to bariatric surgery be extended beyond 2 years for patients with concurrent renal disease?

Abstract

Aims Following bariatric surgery, all patients must be offered a minimum follow up period of 2 years to support patients with potential early and long-term post-operative complications. Patients with end-stage renal disease may need extra support for extended period as micronutrient homeostasis may be impaired long term due to reduced kidney function. This study aims to analyse micronutrient homeostasis of patients with concurrent renal disease and post-op bariatric surgery, to determine need for an extended minimum follow up period. Methods The study was performed in a single referral centre between 2009-2021 and the data was collated from a prospectively collected database. All patients included must have concurrent renal disease and bariatric surgery and followed up for at least 3 years. In addition to clinical variables, micronutrient and metabolic data were collected and analysed. Results A total of 35 patients were included in this study. Micronutrient homeostasis difficulties were recorded in 32 of the 35 patients. Specific micronutrients that were affected includes: vitamin A, B12, folate, ferritin, copper, zinc, selenium, calcium and magnesium. All micronutrient instabilities lasted a period of at least 3 years without a renal transplant. Conclusion Data from this study suggests that patients post bariatric surgery with concurrent renal disease have difficulties maintaining micronutrient homeostasis. This suggests that extending the minimum follow up period and may be necessary to avoid pathological sequalae from micronutrient excess and or deficiency.