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Long-term impact of bariatric surgery in diabetic nephropathy

Abstract

Background

Bariatric surgery has been shown to improve and resolve diabetes. However, limited literature about its impact on end-organ complications of diabetes is available. The aim of this study was to examine the long-term effect of bariatric surgery on albuminuria.

Methods

We studied 101 patients with pre-operative diabetes and albuminuria [defined as urine albumin:creatinine ratio (uACR) > 30 mg/g] who underwent bariatric surgery at an academic center from 2005 to 2014.

Results

Fifty-seven patients (56%) were female with a mean age of 53 (± 11) years. The mean pre-operative BMI and glycated hemoglobin (HbA1c) were 43.1 (± 7.6) kg/m2 and 8.4 (± 1.8)%, respectively. The median pre-operative uACR was 80.0 (45.0–231.0) mg/g. Bariatric procedures included Roux-en-Y gastric bypass (n = 75, 74%) and sleeve gastrectomy (n = 26, 26%). The mean follow-up period was 61 (± 29) months. At last follow-up, the mean BMI was 33.8 (± 8.3) kg/m2. The overall glycemic control improved after bariatric surgery. At last follow-up, 73% had good glycemic control (HbA1c < 7%) and 27% met diabetes remission criteria. The mean HbA1c at last follow-up was 6.7 (± 1.0)% and the median uACR was 30 (IQR 7–94) mg/g. Albuminuria improved in 77% and resolved in 51% of patients at long-term.

Conclusions

Bariatric surgery has a significantly positive impact on albuminuria in patients with obesity and type 2 diabetes. Our data showed almost an 80% improvement in albuminuria at the short- and long-term period after bariatric surgery.

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Fig. 1

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Correspondence to Ali Aminian.

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Disclosures

Authors Young, Nor Hanipah, Brethauer, Schauer, and Aminian have no conflicts of interest or financial ties to disclose.

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Young, L., Nor Hanipah, Z., Brethauer, S.A. et al. Long-term impact of bariatric surgery in diabetic nephropathy. Surg Endosc 33, 1654–1660 (2019). https://doi.org/10.1007/s00464-018-6458-8

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Keywords

  • Bariatric surgery
  • Diabetes
  • Albuminuria
  • Nephropathy
  • Gastric bypass
  • Sleeve gastrectomy