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The Effects of Bariatric Surgery on Renal Outcomes: a Systematic Review and Meta-analysis

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Abstract

Background/Objective

Although promising, data regarding the renal impact and safety of bariatric surgery (BS) are insufficient. We aimed at investigating the benefits and harms of BS for weight loss on kidney function.

Methods

A systematic review and meta-analysis of observational studies reporting data about the impact of BS (any techniques) on serum/plasma creatinine, creatinine clearance, glomerular filtration rate (GFR), proteinuria, nephrolithiasis, and need for renal replacement therapy (RRT)) was performed. Obese adults (non-chronic kidney disease (CKD), CKD or transplanted patients) that underwent BS for weight loss were included. After searching MEDLINE (inception to August 2017), the Cochrane Library (Issue 10–12, October 2017), and the websiteclinicaltrials.gov (August 2017), data were extracted and summarized using a random-effects model.

Results

The final analysis included 23 cohort studies, comprising 3015 participants. Compared with renal function before treatment, BS significantly decreased serum creatinine level (mean difference (MD), − 0.08 mg dl−1; 95% confidence interval (CI), − 0.10 to − 0.06); p < 0.001) and proteinuria (MD, − 0.04 g 24 h−1; 95% CI, − 0.06 to − 0.02; p < 0.001) in the overall group. GFR significantly improved 6 months or more after BS both in the hyperfiltration and CKD subgroups. Renal function also tended to improve in renal transplant patients. Data on nephrolithiasis and the need for RRT were scarce or not reported.

Conclusions

BS apparently has positive effects on kidney function and tends to normalize GFR across different categories of renal impairment (hyperfiltration and CKD patients).

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Funding

The authors have nothing to disclose.

Author information

Author notes

  1. Stefana Catalina Bilha, Ionut Nistor and Alina Nedelcu contributed equally to this work.

Authors and Affiliations

  1. Nephrology Department, “Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania

    Stefana Catalina Bilha, Ionut Nistor, Alina Nedelcu, Dimitrie Siriopol & Adrian Covic

  2. Endocrinology Clinic, “St. Spiridon” Hospital, Iasi, Romania

    Stefana Catalina Bilha

  3. Nephrology Clinic, Dialysis and Renal Transplant Centre, “C. I. Parhon“ University Hospital, Iasi, Romania

    Ionut Nistor, Dimitrie Siriopol & Adrian Covic

  4. European Renal Best Practice (ERBP), Renal Division, Ghent University Hospital, Ghent, Belgium

    Ionut Nistor

  5. Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey

    Mehmet Kanbay

  6. Department of General Surgery, Regional Institute of Oncology, Iasi, Romania

    Viorel Scripcariu

  7. General Surgery Department, “Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania

    Viorel Scripcariu & Daniel Timofte

  8. Department of General Surgery, “St. Spiridon Hospital, Iasi, Romania

    Daniel Timofte

  9. Surgery Department, “St. Spiridon” Hospital, “Grigore T. Popa University of Medicine and Pharmacy, No. 16 University Street, 700115, Iasi, Romania

    Daniel Timofte

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  1. Stefana Catalina Bilha
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  2. Ionut Nistor
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Correspondence to Daniel Timofte.

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Bilha, S.C., Nistor, I., Nedelcu, A. et al. The Effects of Bariatric Surgery on Renal Outcomes: a Systematic Review and Meta-analysis. OBES SURG 28, 3815–3833 (2018). https://doi.org/10.1007/s11695-018-3416-4

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  • DOI: https://doi.org/10.1007/s11695-018-3416-4

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