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Determinants of Evolution of Glomerular Filtration Rate After Bariatric Surgery: a 1-Year Observational Study

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Abstract

Background

Many studies have shown that hyperfiltration induced by obesity decreases after bariatric surgery, while others also showed an increase in glomerular filtration rate (GFR). Furthermore, the factors that influence GFR after bariatric surgery have been poorly studied. The objective was to study the impact of bariatric surgery on renal function and clarify the factors that determine the evolution of GFR after surgery.

Methods

We prospectively evaluated GFR (assessed with 24-h urinary clearance of creatinine) in all patients who underwent bariatric surgery between 2004 and 2014, before and 1 year after surgery. The links between GFR changes and usual clinical and biological parameters were studied.

Results

Three hundred twenty-three patients with complete urine datasets were included (age 43 ± 11 year, M/F 49/274, BMI 46 ± 7 kg/m2). Excess weight loss was 61 ± 24 % and body surface area (BSA) decreased from 2.26 ± 0.23 to 1.98 ± 0.21 m2 (p < 0.001). Mean GFR decreased from 133 ± 37 to 122 ± 49 ml/min (p < 0.001), in parallel to weight loss. However, GFR decreased in subjects with a preoperative GFR >120 ml/min (p < 0.001), was stable in those with 90 < GFR < 120 ml/min, and increased in those with GFR <90 ml/min (p < 0.01). In multivariate analysis, postoperative GFR did not correlate with metabolic parameters but correlated positively with BSA (p < 0.001) and protein intake (p < 0.01) and negatively with age (p < 0.001) and persistence of antihypertensive drugs (p < 0.001) after surgery.

Conclusion

GFR decreased after bariatric surgery in subjects with hyperfiltration, but increased in subjects with renal failure. Changes in body mass, protein intake, and blood pressure appeared to be the main determinants of GFR evolution after surgery.

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Acknowledgments

The authors thank the staff of the obesity center of Hôpital Louis Mourier for their assistance and Pauline Rivière and Marie-Christine Breuil for dietary assessments.

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Authors and Affiliations

  1. Explorations Fonctionnelles, Centre de Référence de l’Obésité, Hôpital Louis Mourier (AP-HP), 178 rue des Renouillers, 92700, Colombes, France

    Muriel Coupaye, Ouidad Sami & Séverine Ledoux

  2. Université Denis Diderot, PRES Sorbonne Paris Cité, Paris, France

    Muriel Coupaye, Martin Flamant, Ouidad Sami, Daniela Calabrese, Simon Msika, Catherine Bogard, Emmanuelle Vidal-Petiot & Séverine Ledoux

  3. Explorations Fonctionnelles, Hôpital Bichat (AP-HP), Paris, France

    Martin Flamant & Emmanuelle Vidal-Petiot

  4. Service de Chirurgie, Centre de Référence de l’Obésité, Hôpital Louis Mourier (AP-HP), 92700, Colombes, France

    Daniela Calabrese & Simon Msika

  5. Service de Biochimie, Hôpital Louis Mourier (AP-HP), 92700, Colombes, France

    Catherine Bogard

Authors
  1. Muriel Coupaye
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  2. Martin Flamant
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  3. Ouidad Sami
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  7. Emmanuelle Vidal-Petiot
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  8. Séverine Ledoux
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Corresponding author

Correspondence to Séverine Ledoux.

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All patients signed an informed consent before surgery and the data collection was approved by our institution and the local ethic committee.

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The authors declare that they have no conflict of interest.

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Coupaye, M., Flamant, M., Sami, O. et al. Determinants of Evolution of Glomerular Filtration Rate After Bariatric Surgery: a 1-Year Observational Study. OBES SURG 27, 126–133 (2017). https://doi.org/10.1007/s11695-016-2260-7

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