The Short-Term Effects of Roux-en-Y Gastric Bypass on Renal Excretion of Sodium and Its Association with Blood Pressure

  • Josue Emiliano López-Martínez
  • Adolfo Chávez-Negrete
  • Arturo Abraham Rodríguez-González
  • Mario Antonio Molina-Ayala
  • Silvia Villanueva-Recillas
  • Pablo Maravilla
  • Aida Monserrat Reséndiz-Barragán
  • Enrique Rentería-Palomo
  • Martín Edgardo Rojano-RodríguezEmail author
Original Contributions



Bariatric surgery has been shown to be effective in reducing weight and has benefits, such as lowering blood pressure. An increase in urinary sodium excretion has been suggested as a possible mechanism. This study explored changes in sodium excretion and their correlation with blood pressure after Roux-en-Y gastric bypass.

Materials and Methods

This study was conducted on 28 obese participants with body mass index (BMI) of 44.54 ± 7.81 kg/m2 who underwent gastric bypass. Before surgery and at the third and sixth months after gastric bypass, blood pressure, urinary sodium concentration, 24-hour (24-h) urinary sodium excretion, and fractional excretion of sodium were evaluated. In addition, serum sodium and potassium levels were determined. Nonparametric tests were used to analyze the data.


Blood pressure decreased after surgery and remained at low levels over the 3- and 6-month periods. The urinary sodium concentration increased at 3 months after surgery; however, the 24-h urinary sodium excretion and urine volume decreased. Interestingly, although some associations between variables were observed, significant correlations between the 24-h urinary sodium excretion and the systolic, diastolic, and mean blood pressures were found. In addition, the urine volume was higher in the sixth month than in the third month following surgery.


In the months immediately following surgery, a low-salt and low-volume diet favors decreases in urine volume and 24-h urinary sodium excretion. In addition, in the sixth month after surgery, an association between blood pressure and 24-h urinary sodium excretion was observed.


Roux-en-Y gastric bypass Bariatric surgery Severe obesity Urinary sodium concentration Blood pressure 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Egger G, Dixon J. Beyond obesity and lifestyle: a review of 21st century chronic disease determinants. Biomed Res Int. 2014; 2014(731685).Google Scholar
  2. 2.
    Gutierrez J, Rivera-Dommarco J, Shamah-Levy T, et al. Encuesta Nacional de Salud y Nutrición 2012. Resultados Nacionales. Cuernavaca, México: Instituto Nacional de Salud Pública (MX); 2012.Google Scholar
  3. 3.
    Flegal KM, Kit BK, Orpana H, et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309(1):71–82.CrossRefGoogle Scholar
  4. 4.
    Campos-Nonato I, Hernández-Barrera L, Rojas-Martínez R, et al. Hipertensión arterial: prevalencia, diagnóstico oportuno, control y tendencias en adultos mexicanos. Salud Publica Mex. 2013;55(sup 2):s151–60.Google Scholar
  5. 5.
    Hall J. The kidney, hypertension, and obesity. Hypertension. 2003;41(2):625–33.Google Scholar
  6. 6.
    Samuelsson AM. New perspectives on the origin of hypertension; the role of the hypothalamic melanocortin system. Exp Physiol. 2014;99(9):110–5.CrossRefGoogle Scholar
  7. 7.
    Vaneckova I, Maletinska L, Behuliak M, et al. Obesity related hypertension:possible pathophysiological mechanism. J Endocrinol. 2014;223(3):63–78.CrossRefGoogle Scholar
  8. 8.
    Hall JE, do Carmo JM, da Silva AA, et al. Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015;116(6):991–1006.CrossRefGoogle Scholar
  9. 9.
    Bray GA, Frühbeck G, Ryan DH, et al. Management of obesity. Lancet. 2016;387(10031):1947–56.CrossRefGoogle Scholar
  10. 10.
    Kushner RF. Weight loss strategies for treatment of obesity. Prog Cardiovasc Dis. 2014;56(4):465–72.CrossRefGoogle Scholar
  11. 11.
    Sugerman HJ, Wolfe LG, Sica DA, et al. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg. 2003;237(6):751–8.Google Scholar
  12. 12.
    Ibargüengoitia MER, Lerman Garber I, Herrera Hernandez MF, et al. Bypass gástrico laparoscópico en Y de Roux y obesidad mórbida. Experiencia en el Instituto Nacional de Ciencias Médicas y Nutrición Salvador Subirán. Rev Investig Clin. 2009;61(3):186–93.Google Scholar
  13. 13.
    Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefGoogle Scholar
  14. 14.
    Vest AR, Heneghan HM, Agarwal S, et al. Bariatric surgery and cardiovascular outcomes:a systematic review. Heart. 2012;98(24):1763–77.CrossRefGoogle Scholar
  15. 15.
    Ricci C, Gaeta M, Rausa E, et al. Early impact of bariatric surgery on type II diabetes, hypertension, and hyperlipidemia: a systematic review, meta-analysis and meta-regression on 6,587 patients. Obes Surg. 2014;24(4):522–8.CrossRefGoogle Scholar
  16. 16.
    Ricci C, Gaeta M, Rausa E, et al. Long-term effects of bariatric surgery on type II diabetes, hypertension and hyperlipidemia: a meta-analysis and meta-regression study with 5-year follow-up. Obes Surg. 2015;25(3):397–405.CrossRefGoogle Scholar
  17. 17.
    Ahmed AR, Rickards G, Coniglio D, et al. Laparoscopic Roux-en-Y gastric bypass and its early effect on blood pressure. Obes Surg. 2009;19(7):845–9.CrossRefGoogle Scholar
  18. 18.
    Adams ST, Salhab M, Hussain ZI, et al. Obesity-related hypertension and its remission following gastricbypass surgery – a review of the mechanisms and predictive factors. Blood Press. 2013;22(3):131–7.CrossRefGoogle Scholar
  19. 19.
    Hallersund P, Sjöström L, Olbers T, et al. Gastric bypass surgery is followed by lowered blood pressure and increased diuresis - long term results from the Swedish Obese Subjects (SOS) Study. PLoS One. 2012;7(11):e49696.CrossRefGoogle Scholar
  20. 20.
    Bueter M, Ashrafian H, Frankel AH, et al. Sodium and water handling after gastric bypass surgery in a rat model. Surg Obes Relat Dis. 2011;7(1):68–73.CrossRefGoogle Scholar
  21. 21.
    Celik F, Ahdi M, Meesters EW, et al. The longer-term effects of Roux-en-Y gastric bypass surgery on sodium excretion. Obes Surg. 2013;23(3):358–64.CrossRefGoogle Scholar
  22. 22.
    Cohn J, Kowey P, Whelton P, et al. New guidelines for potassium replacement in clinical practice. Arch Intern Med. 2000;160(16):2429–36.CrossRefGoogle Scholar
  23. 23.
    Brown IJ, Tzoulaki I, Candeias V, et al. Salt intakes around the world: implications for public health. Int J Epidemiol. 2009;38(3):791–813.CrossRefGoogle Scholar
  24. 24.
    Rose G, Stamler J. The INTERSALT study: background, methods and main results. INTERSALT Co-operative Research Group. J Hum Hypertens. 1989;3(5):283–8.Google Scholar
  25. 25.
    Stamler J, Elliott P, Dennis B, et al. INTERMAP: background, aims, design, methods, and descriptive statistics (nondietary). J Hum Hypertens. 2003;17(9):591–608.CrossRefGoogle Scholar

Copyright information

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

Authors and Affiliations

  • Josue Emiliano López-Martínez
    • 1
  • Adolfo Chávez-Negrete
    • 2
  • Arturo Abraham Rodríguez-González
    • 3
  • Mario Antonio Molina-Ayala
    • 4
  • Silvia Villanueva-Recillas
    • 5
  • Pablo Maravilla
    • 6
  • Aida Monserrat Reséndiz-Barragán
    • 7
  • Enrique Rentería-Palomo
    • 8
  • Martín Edgardo Rojano-Rodríguez
    • 9
    Email author
  1. 1.Department of Continuous Admission ServiceHospital of Specialties at La Raza National Medical Center, IMSSMexico CityMexico
  2. 2.Director of Education and Research in HealthHospital of Specialties at XXI Century National Medical Center, IMSSMexico CityMexico
  3. 3.Department of General and Bariatric SurgeryHospital of Specialties at XXI Century National Medical Center, IMSSMexico CityMexico
  4. 4.Department of Endocrinology and Obesity ClinicHospital of Specialties at XXI Century National Medical Center, IMSSMexico CityMexico
  5. 5.Central Chemistry LaboratoriesGeneral Hospital Dr. Manuel Gea GonzálezMexico CityMexico
  6. 6.Department of Clinical InvestigationGeneral Hospital Dr. Manuel Gea GonzálezMexico CityMexico
  7. 7.Obesity and Metabolic ClinicGeneral Hospital Dr. Manuel Gea GonzálezMexico CityMexico
  8. 8.Department of General and Endoscopic SurgeryGeneral Hospital Dr. Manuel Gea GonzálezMexico CityMexico
  9. 9.Department of Endoscopic, Minimally Invasive Gastrointestinal and Bariatric SurgeryGeneral Hospital Dr. Manuel Gea GonzálezMexico CityMexico

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