Skip to main content
SpringerLink
Log in

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

  • Case Report
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  5. Griffin KA, Kramer H, Bidani AK. Adverse renal consequences of obesity. Am J Physiol Renal Physiol. 2008;294(4):F685–96.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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. Mohr CJ, Nadzam GS, Curet MJ. Totally robotic Roux-en-Y gastric bypass. Arch Surg. 2005;140(8):779–86.

    Article  Google Scholar 

  13. Ogden CL, Yanovski SZ, Carroll MD, et al. The epidemiology of obesity. Gastroenterology. 2007;132(6):2087–102.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  15. Kambham N, Markowitz GS, Valeri AM, et al. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int. 2001;59(4):1498–509.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  19. Schiffl H. Renal recovery after severe acute renal injury. Eur J Med Res. 2008;13(12):552–6.

    CAS  PubMed  Google Scholar 

  20. Agnani S, Vahchharajani VT, Gupta R, et al. Does treating obesity stabilize chronic kidney disease? BMC Nephrol. 2005;6(1):7.

    Article  Google Scholar 

  21. Alexander JW, Goodman H. Gastric bypass in chronic renal failure and renal transplant. Nutr Clin Pract. 2007;22(1):16–21.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA

    B. A. Tafti, M. Haghdoost, M. Curet & M. L. Melcher

  2. Department of Nephrology, Palo Alto Medical Foundation, Palo Alto, CA, USA

    L. Alvarez

  3. Department of Surgery, Division of Multi-Organ Transplantation (MC 5785), Stanford University Medical Center, 750 Welch Road, Suite 200, Palo Alto, CA, 94304, USA

    M. L. Melcher

Authors
  1. B. A. Tafti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Haghdoost
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Alvarez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Curet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. L. Melcher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. L. Melcher.

Additional information

Funding Source

None. The authors have no commercial association that might be a conflict of interest in relation to this article.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tafti, B.A., Haghdoost, M., Alvarez, L. et al. Recovery of Renal Function in a Dialysis-Dependent Patient Following Gastric Bypass Surgery. OBES SURG 19, 1335–1339 (2009). https://doi.org/10.1007/s11695-009-9907-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-009-9907-6

Keywords

Search

Navigation