Longitudinal Impacts of Bariatric Surgery on eGFR in CKD Patients.

IF 3.2 3区 医学 Q1 UROLOGY & NEPHROLOGY
Siddharth S Madapoosi, Lindsey M Kornowske, Kenn B Daratha, Christina L Reynolds, Cami R Jones, Katherine R Tuttle, Laura H Mariani
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引用次数: 0

Abstract

Introduction: Obesity is associated with chronic kidney disease (CKD) incidence and progression. We examined whether bariatric surgery is associated with change in eGFR trajectory among patients with and without CKD.

Methods: Patients who underwent bariatric surgery at two health systems were identified using ICD-9/ICD-10 and CPT codes. Linear mixed models were fit on estimated glomerular filtration rate (eGFR) trajectory pre- and post-surgery among patients with or without CKD. Models were adjusted for age, sex, race, ethnicity, body mass index, hypertension, diabetes, follow-up duration, and type of bariatric surgery. Post-surgery, eGFR trajectory among patients with CKD was also compared following 1:2 propensity score matching to (1) patients without CKD who underwent surgery and (2) patients with CKD who did not undergo surgery.

Results: Patients with CKD (n = 139) at Michigan Medicine had a slower annual rate of eGFR decline post-surgery compared to patients without CKD (n = 278) (1.54 [-2.26, -0.81] vs. 3.15 [-3.41, -2.87] mL/min/1.73 m2; p < 0.001), despite adjusting for degree of weight loss. Among patients with CKD, surgery was associated with a slower annual rate of eGFR decline (-0.20 [-0.83, 0.43] post-surgery vs. -1.11 [-1.37, -0.85] mL/min/1.73 m2 for non-surgery patients; p < 0.001). In an external validation study of patients with CKD in the Providence health system, bariatric surgery predicted an average increase in annualized eGFR slope by 1.19 [0.12, 2.25] mL/min/1.73 m2 (p = 0.03).

Conclusion: Bariatric surgery is associated with less eGFR decline and may have weight-independent effects on preserving kidney function among persons living with obesity and CKD.

减肥手术对慢性肾病患者eGFR的纵向影响。
肥胖与慢性肾脏疾病(CKD)的发生和进展有关。我们研究了减肥手术是否与CKD患者和非CKD患者eGFR轨迹的改变有关。方法:使用ICD-9/ICD-10和CPT代码对在两个卫生系统接受减肥手术的患者进行识别。采用线性混合模型拟合CKD患者术前和术后肾小球滤过率(eGFR)轨迹。模型根据年龄、性别、种族、民族、体重指数、高血压、糖尿病、随访时间和减肥手术类型进行调整。还比较了CKD患者的术后eGFR轨迹,并将1:2倾向评分与(1)接受手术的非CKD患者和(2)未接受手术的CKD患者进行匹配。结果:密歇根医学中心CKD患者(n=139)术后eGFR年下降速度较非CKD患者(n=278)慢(1.54 [-2.26,-0.81]vs. 3.15 [-3.41, -2.87] mL/min/1.73m2;结论:在肥胖和CKD患者中,减肥手术与eGFR下降较少相关,并且可能对维持肾功能具有体重无关的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal of Nephrology
American Journal of Nephrology 医学-泌尿学与肾脏学
CiteScore
7.50
自引率
2.40%
发文量
74
审稿时长
4-8 weeks
期刊介绍: The ''American Journal of Nephrology'' is a peer-reviewed journal that focuses on timely topics in both basic science and clinical research. Papers are divided into several sections, including:
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