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Prevalence of Chronic Kidney Disease in Morbidly Obese Japanese and the Impact of Bariatric Surgery on Disease Progression

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Abstract

Background

The prevalence of chronic kidney disease (CKD) among Japanese morbidly obese patients undergoing bariatric surgery and the impact of bariatric surgery on their renal function has not previously been investigated.

Objectives

The aims were to assess the prevalence of CKD patients who underwent bariatric surgery in our institution and to elucidate the impact of bariatric surgery on their kidney function as measured by the estimated glomerular filtration rate by Cystatin-C (eGFRcys).

Setting

The setting of the study was in a single private hospital.

Methods

Two hundred fifty-four consecutive Japanese patients who underwent bariatric surgery were retrospectively analyzed to elucidate the prevalence of CKD. The eGFRcys was calculated to assess the change in the kidney function for 1 year after surgery.

Results

The preoperative prevalence of CKD was as follows: G1, 45.3%; G2, 47.2%; G3, 6.5%; and G4, 0.9%. The eGFRcys values before and after surgery were compared; the G1 and G2 patients showed significantly improved eGFRcys values after surgery (G1 101 [94–108] vs 114 [103–127]; G2 79 [74–84] vs 97 [87–104] ml/min/1.73 m2; p < 0.01) with significant weight loss (G1 38.1 ± 6.2 vs 26.5 ± 3.4; G2 38.5 ± 6.9 vs 26.7 ± 3.6 kg/m2; p < 0.01). Although the renal function of G3 patients was not improved after surgery (44 [42–47] vs 45 [43–63] ml/min/1.73 m2; p = 0.08), successful weight loss was achieved (36.1 ± 6.3 vs 26.6 ± 3.6 kg/m2; p < 0.01). In multivariate analysis, postoperative eGFRcys correlated negatively with proteinuria (p < 0.01), age (p < 0.01), and body mass index (p < 0.01) and positively with persistence of antihypertensive drugs.

Conclusion

Bariatric surgery resulted in the significant improvement in the eGFRcys values of Japanese patients with morbid obesity, particularly those with pre-CKD (eGFRcys ≥ 60 ml/min/1.73 m2), while the eGFRcys values of CKD patients (< 60 ml/min/1.73 m2) were not ameliorated by surgery.

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Acknowledgements

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Authors and Affiliations

  1. Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan

    Kotaro Wakamatsu, Yosuke Seki, Kazunori Kasama, Kohei Uno & Yoshimochi Kurokawa

  2. Department of Gastrointestinal Surgery, University of Tokyo, Bunkyo, Tokyo, Japan

    Kotaro Wakamatsu & Yasuyuki Seto

  3. Department of Gastroenterological Surgery, National Kyushu Medical Center, Chuo Ward, Fukuoka, Japan

    Kenkichi Hashimoto

Authors
  1. Kotaro Wakamatsu
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  2. Yosuke Seki
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  3. Kazunori Kasama
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  4. Kohei Uno
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  6. Yasuyuki Seto
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  7. Yoshimochi Kurokawa
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Correspondence to Yosuke Seki.

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The authors declare that they have no conflict of interests.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Human and Animal Rights

Our present study has been approved by the appropriate Institutional review board, which is set up in our hospital.

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Wakamatsu, K., Seki, Y., Kasama, K. et al. Prevalence of Chronic Kidney Disease in Morbidly Obese Japanese and the Impact of Bariatric Surgery on Disease Progression. OBES SURG 28, 489–496 (2018). https://doi.org/10.1007/s11695-017-2863-7

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  • DOI: https://doi.org/10.1007/s11695-017-2863-7

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