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Incidence of Kidney Stones After Bariatric Surgeries: Comparing Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

  • Original Article
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Journal of Gastrointestinal Surgery

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Abstract

Introduction/Purpose

The two most common procedures performed to treat obesity are Roux-En-Y gastric bypass (RNYGB) and laparoscopic sleeve gastrectomy (LSG). Due to changes in enteric absorption, bariatric surgery increases rates of nephrolithiasis. As population-based data are limited, we aimed to compare the incidence of kidney stones after RNYGB and LSG.

Materials and Methods

We queried Explorys (Cleveland, OH), a database that aggregated data from 26 healthcare systems. We identified patients who were newly diagnosed with nephrolithiasis 3, 6, and 12 months after their RNYGB or LSG. Additionally, a multivariate analysis was conducted to investigate the association of nephrolithiasis with RNYGB as compared to LSG. This analysis adjusted for other risk factors, including age above 65, male gender, Caucasian race, diabetes mellitus, hypertension, primary hyperparathyroidism, gout, and obesity.

Results

From 1999 to 2019, there were 11,480 patients who underwent RNYGB and 22,770 patients who underwent LSG. The incidence of nephrolithiasis in the RNYGB cohort at all three time points was higher than in the LSG cohort (3 months, 7.1% vs. 2.4%; 6 months, 6.6% vs. 2.0%; 1 year, 5.8% vs. 1.4%; P < 0.001). After the multivariate analysis, it was found that, though both RNYGB and LSG were independently associated with the development of nephrolithiasis, the risk of nephrolithiasis was higher in those who underwent RNYGB compared to those who underwent LSG (OR 1.594, 95% CI 1.494 to 1.701, P < 0.001).

Conclusion

RNYGB is associated with a higher risk of nephrolithiasis when compared to LSG.

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Data Availability

All data is available in body of manuscript, as well as the supplementary material.

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Acknowledgements

Thank you to each of our departments in their support of our research.

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Hepatology, and Nutrition, UPMC, Mezzanine Level, C-Wing, PUH, 200 Lothrop St, Pittsburgh, PA, 15213, USA

    Kyle Hoffman

  2. Department of Medicine, University Hospitals, Cleveland, OH, USA

    Kyle Hoffman

  3. Division of Gastroenterology, Hepatology, and Endoscopy, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA

    Raj Shah

  4. Division of Gastroenterology, Hepatology, and Nutrition, University at Buffalo, Buffalo, NY, USA

    Mayada Ismail

  5. Division of Gastroenterology and Hepatology, University of Texas at Austin, Austin, TX, USA

    Sagarika Satyavada

  6. Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, OH, USA

    Mo’tasem Alkhayyat

  7. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Emad Mansoor & Gregory Cooper

  8. Gastroenterology and Hepatology Section, VA Northeast Ohio Healthcare System, Cleveland, OH, USA

    Emad Mansoor

  9. Digestive Health Institute, University Hospitals Cleveland Medical Center/Seidman Cancer Center, Cleveland, OH, USA

    Gregory Cooper

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  1. Kyle Hoffman
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  2. Raj Shah
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  7. Gregory Cooper
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Corresponding author

Correspondence to Kyle Hoffman.

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Ethical Approval

As this study utilized a de-identified database, the study was considered exempt from the need for IRB approval at University Hospitals.

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The authors declare no competing interests.

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Key Points

• RNYGB is associated with a higher risk of nephrolithiasis when compared to LSG.

• LSG may be preferred in those who have a predisposition for nephrolithiasis.

• Further studies may indicate need for prophylactic measures for high-risk groups.

Supplementary Information

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Supplementary file1 (XLSX 95 KB)

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Hoffman, K., Shah, R., Ismail, M. et al. Incidence of Kidney Stones After Bariatric Surgeries: Comparing Roux-en-Y Gastric Bypass and Sleeve Gastrectomy. J Gastrointest Surg 27, 2336–2341 (2023). https://doi.org/10.1007/s11605-023-05849-9

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  • DOI: https://doi.org/10.1007/s11605-023-05849-9

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