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Comparative Study
. 2018 Dec 29;19(1):383.
doi: 10.1186/s12882-018-1188-7.

Measurement of glomerular filtration rate in patients undergoing obesity surgery

Ling L Chuah  1 , Alexander D Miras  1 , Laura M Perry  2 , Andrew H Frankel  3 , David J Towey  2 , Zahraa Al-Mayahi  4 , William Svensson  5 , Carel W le Roux  1   6   7
Affiliations
Comparative Study

Measurement of glomerular filtration rate in patients undergoing obesity surgery

Ling L Chuah et al. BMC Nephrol. .

Abstract

Background: Most studies on obesity surgery have measured renal function using the estimated GFR. However, due to the reduction of muscle mass, and therefore creatinine that accompanies weight loss, such measures can falsely suggest an improvement in renal function. To balance the risks of surgery versus any potential benefits on renal function, we need to be able to determine renal function using valid and reliable methodologies. In this pilot study we aimed to measure renal function in patients with CKD undergoing obesity surgery using the gold standard 51Cr-EDTA GFR clearance methodology which is independent of measures of muscle mass.

Methods: Nine consecutive obese patients with CKD underwent obesity surgery. Their renal function was assessed using 51Cr-EDTA GFR, cystatin C and serum creatinine as well as using eGFR equations including MDRD CKD Epi, Cockcroft Gault and CKD Epi cystatin before and 12 months after surgery.

Results: Renal function using the 51Cr-EDTA measured GFR did not change significantly after surgery. Similar results were obtained when Cystatin C, CKD Epi cystatin, CKD Epi cystatin creatinine and adjusted Cockcroft Gault Creatinine clearance methods were used. In contrast there were either trends or significant improvements in renal function measured using the MDRD and CKD Epi equations.

Conclusions: In this pilot study using the gold standard 51Cr-EDTA method we found stabilisation in renal function after obesity surgery. Until further definitive data emerge it is critical to balance the risk and benefits of surgery, especially if renal function may not improve as often as previously suggested.

Trial registration: ClinicalTrials.gov NCT01507350 . Registered June 2011.

Keywords: Bariatric; Cr-EDTA; Creatinine; GFR; Renal.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the local research and ethics committee (West London Research Ethics Committee, Reference 10/H0707/96). Patients provided written informed consent and the study was conducted according to the principles of the Helsinki declaration.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Individual 51Cr-EDTA GFR measurements before and after obesity surgery
See this image and copyright information in PMC

References

    1. Friedman AN, Wolfe BI. Bariatric Surgery an effective treatment for type II diabetic kidney disease? Clin J Am Soc Nephrol. 2016;11(3):528–535. doi: 10.2215/CJN.07670715. - DOI - PMC - PubMed
    1. Li K, Zou J, Ye Z, et al. Effects of Bariatric Surgery on renal Function in obese patients: a systematic review and Meta analysis. PLoS One. 2016;11(10):e0163907. doi: 10.1371/journal.pone.0163907. - DOI - PMC - PubMed
    1. Miras AD, Chuah LL, Khalil N, et al. Type 2 diabetes mellitus and microvascular complications 1 year after roux-en-Y gastric bypass: a case–control study. Diabetologia. 2015;58(7):1443–1447. doi: 10.1007/s00125-015-3595-7. - DOI - PMC - PubMed
    1. Chang AR, Grams ME, Navaneethan SD. Bariatric Surgery and Kidney-Related Outcomes. Kidney Int Rep. 2017;2(2):261–270. doi: 10.1016/j.ekir.2017.01.010. - DOI - PMC - PubMed
    1. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann Intern Med. 1999;130(6):461–470. doi: 10.7326/0003-4819-130-6-199903160-00002. - DOI - PubMed

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