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Effect of Drastic Weight Loss after Bariatric Surgery on Renal Parameters in Extremely Obese Patients: Long-Term Follow-Up

Maruja Navarro-Díaz^*, Assumpta Serra^*, Ramón Romero^*, Josep Bonet^*, Beatriu Bayés^*, Mercé Homs^*, Noelia Pérez and Jordi Bonal^*

Departments of ^* Nephrology and General Surgery, "Germans Trias i Pujol" Hospital, Department of Medicine, Universidad Autónoma de Barcelona, Barcelona, Spain

Address correspondence to: Dr. Ramón Romero, Department of Nephrology, "Germans Trias y Pujol" Hospital, Carretera de Canyet, s/n Badalona, 08916 Barcelona, Spain. Phone: +34-93-497-8898; Fax: +34-93-497-8852; E-mail: r.romero{at}uab.es

Obesity is a health problem that is reaching epidemic proportions. Extreme obesity (body mass index [BMI] 40 kg/m²) is a type of obesity that usually does not respond to medical treatment, with surgery being the current treatment of choice. Extreme obesity is associated with cardiovascular disease, type 2 diabetes, dyslipidemia, and hypertension. Recently, obesity has been related with high rate of renal lesions, but renal function and renal parameters in extreme obesity scarcely are documented. The objective of this study was to evaluate the effect of weight loss after bariatric surgery (BS) on BP, renal parameters, and renal function in 61 extremely obese (EO) patients after 24 mo of follow-up. A total of 61 EO adults (37 women) were studied prospectively before and 24 mo after surgery. Control subjects were 24 healthy, normal-weight adults (15 women). Anthropometric, BP, and renal parameters were determined. Presurgery weight, BMI, GFR, 24-h proteinuria, and 24-h albuminuria were higher in the EO patients than in control subjects (P < 0.001). All parameters improved at 12 mo after BS. However, during the second year of follow-up, only 24-h albuminuria (P = 0.006) and BMI (P = 0.014) continued to improve. At 24 mo after BS, obesity-related renal alterations considerably improved. This improvement was observed mainly in the first year after surgery, when the majority of weight loss occurred. However, 24-h albuminuria still improves during the second year of follow-up. It is possible that this decrease in 24-h albuminuria is not GFR related but rather is attributable to the persistence of the decrease in BMI and to the improvement of other weight-related metabolic factors.

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Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673