Weight-Loss Surgery Safe for Obese Kidney Disease Patients

Weight-loss surgery is safe for chronic kidney disease (CKD) patients who are obese, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The study is the largest of its kind to focus on the impact of kidney function on patients’ health following weight-loss surgery.

It’s not known whether weight-loss surgery-also known as bariatric surgery-is safe for patients with CKD or how diminished kidney function might impact the risks of the procedure. To find out, Nicole Turgeon, MD, John Sweeney, MD (Emory University School of Medicine), and their colleagues analyzed information from 27,736 patients who underwent weight-loss surgery between 2006 and 2008.

The researchers found that patients with more severe CKD experienced more complications following surgery. Complication rates ranged from 4.6% for those with stage 1 CKD or normal kidney function to 9.9% for those with stage 5 CKD.

Even though patients with more severe CKD experienced more complications, complication rates remained below 10%. "This work provides strong evidence that it is safe to proceed with bariatric surgery in kidney failure patients who suffer from obesity," said Dr. Sweeney.

The findings are encouraging because maintaining weight loss is challenging for CKD patients, many of whom have a decreased ability to exercise. Also, obesity can limit CKD patients’ eligibility for kidney transplants. Whether the potential benefits of weight-loss surgery outweigh the risks in this population requires further study, though.

Study co-authors include Sebastian Perez, Max Mondestin, MD, S. Scott Davis, MD, Edward Lin, DO, Sudha Tata, MD, Allan Kirk, MD, PhD, Christian Larsen, MD, DPhil, Thomas Pearson, MD, DPhil (Emory University School of Medicine).

Disclosures: The authors reported no financial disclosures.

The article, entitled "The Impact of Renal Function on Outcomes of Bariatric Surgery," will appear online at http://jasn.asnjournals.org/ on March 1, 2012, doi: 10.1681/ASN.2011050476.

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