Siddharth S Madapoosi, Lindsey M Kornowske, Kenn B Daratha, Christina L Reynolds, Cami R Jones, Katherine R Tuttle, Laura H Mariani
{"title":"Longitudinal Impacts of Bariatric Surgery on eGFR in CKD Patients.","authors":"Siddharth S Madapoosi, Lindsey M Kornowske, Kenn B Daratha, Christina L Reynolds, Cami R Jones, Katherine R Tuttle, Laura H Mariani","doi":"10.1159/000547339","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1-11"},"PeriodicalIF":3.2000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453692/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000547339","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
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.
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: