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Impact of rapid weight loss after bariatric surgery on the prevalence of arterial hypertension in severely obese patients with chronic kidney disease

  • Camila Ortiz-Gomez
  • David Romero-Funes
  • David Gutierrez-Blanco
  • Joel S. Frieder
  • Maria Fonseca-Mora
  • Emanuele Lo Menzo
  • Samuel Szomstein
  • Raul J. RosenthalEmail author
2019 SAGES Oral
  • 17 Downloads

Abstract

Background

Arterial hypertension (HTN) is one of the most important risk factors for the development and progression of chronic kidney disease (CKD). Rapid weight loss after bariatric interventions has a positive impact on blood pressure levels of hypertensive patients. The aim of our study is to assess the prevalence of HTN in patients with CKD after bariatric surgery (BS).

Methods

We retrospectively reviewed severely obese patients who underwent BS from 2010 to 2017. We used guidelines of the American College of Cardiology to define HTN. Only patients meeting ACC criteria and the calculation of estimated glomerular filtration rate (eGFR) using CKD epidemiology collaboration study equation preoperatively and at 12-month follow-up were included in the analysis.

Results

From a total of 2900 patients, 29.13% (845) met the required criteria and had variables for the calculation of eGFR recorded preoperatively. 36.92% (312) had preoperative HTN and s classified as CKD stage ≥ 2. We observed a predominantly female population 63.83% (203) with mean age of 54.10 ± 11.58. Patients preoperatively classified in CKD 2, 3a, and 3b exhibited the greatest prevalence reduction of HTN at 12-month follow-up (68.59%, n = 214 vs. 36.59%, n = 114; 16.67%, n = 52 vs. 6.41%, n = 20; 7.69%, n = 24 vs. 1.28%, n = 4; p < 0.0001). A marked improvement in CKD was also observed along with improvement in HTN. The greatest benefit corresponded to patients classified preoperatively in CKD 2, 3a and 3b. A total of n = 70 (62.5%) patients with HTN were classified as CKD 2 preoperatively compared to n = 55 (49.11%) at 12-month follow-up (p = 0.0436). Similarly, n = 22 (19.64%) patients with HTN were classified preoperatively as CKD 3a compared to n = 7 (6.25%) and n = 12 (10.71%) patients as CKD 3b compared to n = 4 (3.57%) during the same time period (p = 0.0028, p = 0.0379, respectively).

Conclusions

Rapid weight loss after BS significantly reduces prevalence of HTN in all stages of CKD at 12-month follow-up. Additionally, there was a positive impact on classification of CKD at 12-month follow-up.

Keywords

Bariatric surgery Weight loss Outcomes Comorbidity remission Hypertension Chronic kidney disease 

Notes

Compliance with ethical standards

Disclosures

Camila Ortiz‑Gomez, David Romero‑Funes, David Gutierrez‑Blanco, Joel S. Frieder, Maria Fonseca‑Mora, Emanuele Lo Menzo, Samuel Szomstein, and Raul J. Rosenthal have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Camila Ortiz-Gomez
    • 1
  • David Romero-Funes
    • 1
  • David Gutierrez-Blanco
    • 1
  • Joel S. Frieder
    • 1
  • Maria Fonseca-Mora
    • 1
  • Emanuele Lo Menzo
    • 1
  • Samuel Szomstein
    • 1
  • Raul J. Rosenthal
    • 1
    Email author
  1. 1.Department of General Surgery and the Bariatric and Metabolic InstituteCleveland Clinic FloridaWestonUSA

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