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Acute Kidney Injury Following Bariatric Surgery

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Abstract

Background

Postoperative acute kidney injury (AKI) following bariatric surgery has not been well studied. The aim of this study is to identify factors associated with risk of AKI.

Methods

The medical records of adult patients who underwent bariatric surgery between March 1, 2005 and March 31, 2011 at the Mayo Clinic were reviewed to identify patients who experienced AKI, defined as postoperative increase in serum creatinine (sCr) by 0.3 mg/dL within 72 h. For each AKI case, two controls were matched for surgical approach (laparotomy vs. laparoscopic). A chart review was conducted and conditional logistic regression analyses were performed to identify risk factors for AKI.

Results

There were 1,227 patients who underwent bariatric surgery, and of these, 71 developed AKI (5.8 %). The median sCr increase was 0.4 (interquartile range 0.3–0.6) mg/dL. Independent patient factors associated with increased risk included higher body mass index [odds ratio (OR) 1.24, 95 % CI 1.06–1.46 per 5 unit increase, P = 0.01] and medically treated diabetes mellitus (OR 2.77, 1.36–5.65, P = 0.01). Patients experiencing AKI had higher rates of blood transfusions (P < 0.01), postsurgical complications (P < 0.01), and longer hospital stays (P < 0.01). Another 30 patients developed kidney injury after 72 postoperative hours, usually in the setting of dehydration.

Conclusions

Kidney injury following bariatric surgery is not uncommon and is associated with higher body mass index and diabetes. Further, there should be a high risk of suspicion for kidney injury in postoperative patients developing volume depletion.

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Acknowledgments

This project was supported by the Department of Anesthesiology, College of Medicine, Mayo Clinic and NIH/NCRR CTSA Grant Numbers UL1 RR024150 and KL2 RR024151. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Conflict of interest

None of the authors have conflicts of interest to report.

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Authors and Affiliations

  1. Department of Anesthesiology, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA

    Toby N. Weingarten, Carmelina Gurrieri, Joan M. McCaffrey, Starla J. Ricter, Mandy L. Hilgeman & Juraj Sprung

  2. Department of Health Sciences Research, Division of Biostatistics and Informatics, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA

    Darrell R. Schroeder

  3. Department of General and Gastrointestinal Surgery, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA

    Michael L. Kendrick

  4. Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA

    Eddie L. Greene

Authors
  1. Toby N. Weingarten
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  2. Carmelina Gurrieri
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  3. Joan M. McCaffrey
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  4. Starla J. Ricter
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  5. Mandy L. Hilgeman
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  6. Darrell R. Schroeder
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  7. Michael L. Kendrick
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  8. Eddie L. Greene
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  9. Juraj Sprung
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Corresponding author

Correspondence to Toby N. Weingarten.

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Weingarten, T.N., Gurrieri, C., McCaffrey, J.M. et al. Acute Kidney Injury Following Bariatric Surgery. OBES SURG 23, 64–70 (2013). https://doi.org/10.1007/s11695-012-0766-1

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  • DOI: https://doi.org/10.1007/s11695-012-0766-1

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