Obesity Surgery

, Volume 19, Issue 9, pp 1335–1339 | Cite as

Recovery of Renal Function in a Dialysis-Dependent Patient Following Gastric Bypass Surgery

  • B. A. Tafti
  • M. Haghdoost
  • L. Alvarez
  • M. Curet
  • M. L. Melcher
Case Report


There is increasing evidence that obesity, independently from other comorbidities such as diabetes and hypertension, can cause renal dysfunction. While this indolent dysfunction may be asymptomatic, it can render patients more susceptible to renal insufficiency when the kidneys are further injured by other pathological processes. Here, we present a morbidly obese patient whose type-A aortic dissection was complicated by acute renal failure that subsequently progressed into end-stage renal disease. However, his renal function improved dramatically following substantial weight reduction after gastric bypass surgery obviating the need for dialysis and transplantation. The potential mechanisms by which a patient’s obesity may lead to renal dysfunction are discussed. This case and other similar reports suggest that obese patients with renal failure can safely undergo bariatric surgery and that bariatric surgery may have a role in treating chronic kidney disease in select morbidly obese patients.


Acute renal failure Chronic kidney disease Aortic aneurysm Obesity Dialysis Gastric bypass surgery. 


  1. 1.
    Geirsson A, Szeto WY, Pochettino A, et al. Significance of malperfusion syndromes prior to contemporary surgical repair for acute type A dissection: outcomes and need for additional revascularizations. Eur J Cardiothorac Surg. 2007;32(2):255–62.PubMedCrossRefGoogle Scholar
  2. 2.
    Yagdi T, Atay Y, Engin C, et al. Impact of organ malperfusion on mortality and morbidity in acute type A aortic dissections. J Card Surg. 2006;21(4):363–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Bown MJ, Norwood MG, Sayers RD. The management of abdominal aortic aneurysms in patients with concurrent renal impairment. Eur J Vasc Endovasc Surg. 2005;30(1):1–11.PubMedCrossRefGoogle Scholar
  4. 4.
    Godet G, Fleron MH, Vicaut E, et al. Risk factors for acute postoperative renal failure in thoracic or thoracoabdominal aortic surgery: a prospective study. Anesth Analg. 1997;85(6):1227–32.PubMedCrossRefGoogle Scholar
  5. 5.
    Griffin KA, Kramer H, Bidani AK. Adverse renal consequences of obesity. Am J Physiol Renal Physiol. 2008;294(4):F685–96.PubMedCrossRefGoogle Scholar
  6. 6.
    Wahba IM, Mak RH. Obesity and obesity-initiated metabolic syndrome: mechanistic links to chronic kidney disease. Clin J Am Soc Nephrol. 2007;2(3):550–62.PubMedCrossRefGoogle Scholar
  7. 7.
    Chagnac A, Weinstein T, Herman M, et al. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol. 2003;14(6):1480–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Perez G, Devaud N, Escalona A, et al. Resolution of early stage diabetic nephropathy in an obese diabetic patient after gastric bypass. Obes Surg. 2006;16(10):1388–91.PubMedCrossRefGoogle Scholar
  9. 9.
    Izzedine H, Coupaye M, Reach I, et al. Gastric bypass and resolution of proteinuria in an obese diabetic patient. Diabet Med. 2005;22(12):1761–2.PubMedCrossRefGoogle Scholar
  10. 10.
    Navarro-Diaz M, Serra A, Romero R, et al. Effect of drastic weight loss after bariatric surgery on renal parameters in extremely obese patients: long-term follow-up. J Am Soc Nephrol. 2006;17(12 Suppl 3):S213–7.PubMedCrossRefGoogle Scholar
  11. 11.
    NIH. Initiation and maintenance of weight loss after laparoscopic adjustable gastric banding. NIH Consensus Statement Online. 1991;9(1):1–20.Google Scholar
  12. 12.
    Mohr CJ, Nadzam GS, Curet MJ. Totally robotic Roux-en-Y gastric bypass. Arch Surg. 2005;140(8):779–86.PubMedCrossRefGoogle Scholar
  13. 13.
    Ogden CL, Yanovski SZ, Carroll MD, et al. The epidemiology of obesity. Gastroenterology. 2007;132(6):2087–102.PubMedCrossRefGoogle Scholar
  14. 14.
    Wang Y, Chen X, Song Y, et al. Association between obesity and kidney disease: a systematic review and meta-analysis. Kidney Int. 2008;73(1):19–33.PubMedCrossRefGoogle Scholar
  15. 15.
    Kambham N, Markowitz GS, Valeri AM, et al. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int. 2001;59(4):1498–509.PubMedCrossRefGoogle Scholar
  16. 16.
    Praga M, Morales E, Herrero JC, et al. Absence of hypoalbuminemia despite massive proteinuria in focal segmental glomerulosclerosis secondary to hyperfiltration. Am J Kidney Dis. 1999;33(1):52–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Praga M, Hérnandez E, Herrero JC, et al. Influence of obesity on the appearance of proteinuria and renal insufficiency after unilateral nephrectomy. Kidney Int. 2000;58(5):2111–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Bouldin MJ, Ross LA, Sumrall CD, et al. The effect of obesity surgery on obesity comorbidity. Am J Med Sci. 2006;331(4):183–93.PubMedCrossRefGoogle Scholar
  19. 19.
    Schiffl H. Renal recovery after severe acute renal injury. Eur J Med Res. 2008;13(12):552–6.PubMedGoogle Scholar
  20. 20.
    Agnani S, Vahchharajani VT, Gupta R, et al. Does treating obesity stabilize chronic kidney disease? BMC Nephrol. 2005;6(1):7.PubMedCrossRefGoogle Scholar
  21. 21.
    Alexander JW, Goodman H. Gastric bypass in chronic renal failure and renal transplant. Nutr Clin Pract. 2007;22(1):16–21.PubMedCrossRefGoogle Scholar
  22. 22.
    Cuda SP, Chung MH, Denunzio TM, et al. Reduction of proteinuria after gastric bypass surgery: case presentation and management. Surg Obes Relat Dis. 2005;1(1):64–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Soto FC, Higa-Sansone G, Copley JB, et al. Renal failure, glomerulonephritis and morbid obesity: improvement after rapid weight loss following laparoscopic gastric bypass. Obes Surg. 2005;15(1):137–40.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • B. A. Tafti
    • 1
  • M. Haghdoost
    • 1
  • L. Alvarez
    • 2
  • M. Curet
    • 1
  • M. L. Melcher
    • 1
    • 3
  1. 1.Department of SurgeryStanford University School of MedicineStanfordUSA
  2. 2.Department of NephrologyPalo Alto Medical FoundationPalo AltoUSA
  3. 3.Department of Surgery, Division of Multi-Organ Transplantation (MC 5785)Stanford University Medical CenterPalo AltoUSA

Personalised recommendations