Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 29;11(3):728.
doi: 10.3390/jcm11030728.

Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity

Anna Oliveras  1   2   3   4 , Susana Vázquez  1   2 , María José Soler  5 , Isabel Galceran  1   2 , Xavier Duran  2 , Albert Goday  2   6   7 , David Benaiges  2   6   7 , Marta Crespo  1   2   3   4 , Julio Pascual  1   2 , Marta Riera  2   4
Affiliations

Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity

Anna Oliveras et al. J Clin Med. .

Abstract

Obesity-related hyperfiltration leads to an increased glomerular filtration rate (GFR) and hyperalbuminuria. These changes are reversible after bariatric surgery (BS). We aimed to explore obesity-related renal changes post-BS and to seek potential mechanisms. Sixty-two individuals with severe obesity were prospectively examined before and 3, 6 and 12 months post-BS. Anthropometric and laboratory data, 24 h-blood pressure, renin-angiotensin-aldosterone system (RAS) components, adipokines and inflammatory markers were determined. Both estimated GFR (eGFR) and albuminuria decreased from the baseline at all follow-up times (p-for-trend <0.001 for both). There was a median (IQR) of 30.5% (26.2-34.4) reduction in body weight. Plasma glucose, glycosylated hemoglobin, fasting insulin and HOMA-index decreased at 3, 6 and 12 months of follow-up (p-for-trend <0.001 for all). The plasma aldosterone concentration (median (IQR)) also decreased at 12 months (from 87.8 ng/dL (56.8; 154) to 65.4 (56.8; 84.6), p = 0.003). Both leptin and hs-CRP decreased (p < 0.001) and adiponectine levels increased at 12 months post-BS (p = 0.017). Linear mixed-models showed that body weight (coef. 0.62, 95% CI: 0.32 to 0.93, p < 0.001) and plasma aldosterone (coef. -0.07, 95% CI: -0.13 to -0.02, p = 0.005) were the independent variables for changes in eGFR. Conversely, glycosylated hemoglobin was the only independent variable for changes in albuminuria (coef. 0.24, 95% CI: 0.06 to 0.42, p = 0.009). In conclusion, body weight and aldosterone are the main factors that mediate eGFR changes in obesity and BS, while albuminuria is associated with glucose homeostasis.

Keywords: albuminuria; aldosterone; bariatric surgery; glucose metabolism; hyperfiltration; renin-angiotensin axis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or the writing of the report.

Figures

Figure 1
Figure 1
The changes in eGFR (1A) and albuminuria (1B) from baseline (before BS) to 12 months post-BS, with mid-points at 3 and 6 months. eGFR-CG = estimated glomerular filtration rate by the Cockcroft-Gault equation; lnACR = neperian logarithm of albumin-creatinine ratio. Values of both eGFR-CG and lnACR are given as mean ± SD.
Figure 2
Figure 2
The changes in fasting glucose from baseline (before BS) to 12-months of follow-up, with mid-points at 3 and 6 months. Values of fasting glucose are given as the mean and corresponding 95% confidence intervals.
Figure 3
Figure 3
The changes in glycosylated hemoglobin, fasting insulin and HOMA-IR index from baseline (before BS) to 12-months of follow-up. HbA1c = glycosylated hemoglobin; HOMA = homeostasis model assessment-estimated insulin resistance.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Effect of bariatric surgery on HDL-mediated cholesterol efflux capacity.
    Castañer O, Pérez-Vega KA, Álvarez S, Vázquez S, Casajoana A, Blanchart G, Gaixas S, Schröder H, Zomeño MD, Subirana I, Muñoz-Aguayo D, Fitó M, Benaiges D, Goday A, Oliveras A. Castañer O, et al. Front Cardiovasc Med. 2024 Nov 7;11:1469433. doi: 10.3389/fcvm.2024.1469433. eCollection 2024. Front Cardiovasc Med. 2024. PMID: 39574780 Free PMC article.
  • Renal Dysfunction Phenotypes in Patients Undergoing Obesity Surgery.
    Pereira PR, Pereira J, Braga PC, Pereira SS, Nora M, Guimarães M, Monteiro MP, Rodrigues A. Pereira PR, et al. Biomolecules. 2023 May 3;13(5):790. doi: 10.3390/biom13050790. Biomolecules. 2023. PMID: 37238660 Free PMC article.

References

    1. WHO Organization Obesity and Overweight. 2018. [(accessed on 19 December 2021)]. Available online: https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight.
    1. Pi-Sunyer X. The Medical Risks of Obesity. Postgrad. Med. 2009;121:21–33. doi: 10.3810/pgm.2009.11.2074. - DOI - PMC - PubMed
    1. Koch V.H. Obesity Facts and Their Influence on Renal Function Across the Life Span. Front. Med. 2021;8:704409. doi: 10.3389/fmed.2021.704409. - DOI - PMC - PubMed
    1. Favre G., Anty R., Canivet C., Clément G., Ben-Amor I., Tran A., Gugenheim J., Gual P., Esnault V.L., Iannelli A. Determinants associated with the correction of glomerular hyper-filtration one year after bariatric surgery. Surg. Obes. Relat. Dis. 2017;13:1760–1766. doi: 10.1016/j.soard.2017.07.018. - DOI - PubMed
    1. Rosenstock J.L., Pommier M., Stoffels G., Patel S., Michelis M.F. Prevalence of Proteinuria and Albuminuria in an Obese Pop-ulation and Associated Risk Factors. Front. Med. 2018;5:122. doi: 10.3389/fmed.2018.00122. - DOI - PMC - PubMed