Obesity Surgery

, Volume 23, Issue 5, pp 634–637

The Effect of Biliopancreatic Diversion Surgery on Renal Function—a Retrospective Study

Authors

  • Biju Jose
    • Specialist Weight Management ServicesHeart of England Foundation NHS Trust
  • Stephen Ford
    • Department of Renal Medicine, Heart of England Foundation NHS TrustBirmingham Heartlands Hospital
  • Paul Super
    • Specialist Weight Management ServicesHeart of England Foundation NHS Trust
    • Department of Bariatric and Upper Gastrointestinal SurgeryHeart of England Foundation NHS Trust
  • G. Neil Thomas
    • School of Health and Population SciencesUniversity of Birmingham
    • Department of Renal Medicine, Heart of England Foundation NHS TrustBirmingham Heartlands Hospital
    • Specialist Weight Management ServicesHeart of England Foundation NHS Trust
    • School of Clinical and Experimental MedicineUniversity of Birmingham, and Birmingham and Black Country NIHR CLAHRC
Clinical Research

DOI: 10.1007/s11695-012-0851-5

Cite this article as:
Jose, B., Ford, S., Super, P. et al. OBES SURG (2013) 23: 634. doi:10.1007/s11695-012-0851-5

Abstract

Background

The prevalences of obesity and chronic kidney disease (CKD) have increased simultaneously. Should a pathophysiological relationship exist between the two conditions, bariatric surgery and associated weight loss could be an important intervention in extremely obese individuals to slow the progression of CKD.

Methods

We conducted a retrospective analysis of 25 patients who had undergone biliopancreatic diversion (BPD) surgery for extreme obesity (body mass index >40 kg/m2), with mean follow-up of 4 years. We assessed pre- and post-surgery renal function, body weight and blood pressure (BP) obtained from electronic hospital and primary care records.

Results

There was a significant reduction in mean body weight at 4 years by 50.3 kg (SD = 20.65). The creatinine and estimated glomerular filtration rate (eGFR) also improved significantly: serum creatinine reduced by 16.2 μmol/l (SD = 19.57) while the eGFR improved by 10.6 ml/min/m2 (SD = 15.45). The greatest improvement in eGFR was in the group (n = 7) with eGFR ≤60 ml/min/m2. A subset of patients (n = 11) had evaluable BP readings and had a reduction in BP of 17/10 mmHg (SD = 33/12).

Conclusions

This retrospective study demonstrates a clinically significant improvement in renal function following BPD. Several mechanisms including weight loss could account for the positive impact on renal function. The physiology underlying this improvement requires further study.

Keywords

ObesityRenal functionWeight lossBariatric surgery

Copyright information

© Springer Science+Business Media New York 2013