b05532f8382f023dcfd8f7bd12096c4d pmc_35160179.pdf 2073c6fbaece213e0da891de5f4d43adfa62e4f1 pmc_35160179.pdf 66c05d7b4b05edce63f0869b2cb5910f091612bf1b783e50d60fb5e3365ad420 pmc_35160179.pdf Title: Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity Subject: 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: bariatric surgery; hyperfiltration; albuminuria; renin-angiotensin axis; aldosterone; glucose metabolism Author: Anna Oliveras, Susana Vázquez, María José Soler, Isabel Galceran, Xavier Duran, Albert Goday, David Benaiges, Marta Crespo, Julio Pascual and Marta Riera Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Feb 9 08:12:47 2022 CET ModDate: Wed Feb 9 08:16:11 2022 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 844475 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UEHGBQ+VnURWPalladioL Type 1 Custom yes yes no 10 0 WPSSFY+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 ZVJXDW+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 WZFXRS+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 BVKSVL+CMSY10 Type 1 Builtin yes yes no 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TrueType Identity-H yes yes yes 141 0 BDPBBL+PalatinoLinotype TrueType WinAnsi yes yes no 147 0 BDPBBN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 150 0 BDPAOK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 160 0 BDPBBL+PalatinoLinotype TrueType WinAnsi yes yes no 163 0 BDPBBN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 166 0 BDPCJI+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 169 0 UNSLQC+EURM10 Type 1 Builtin yes yes no 182 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-09-16 02:36:01 CEST RepresentationInformation: pmc_35160179.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-02-27 18:42:51 CET Size: 844475 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 338 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Children: Item: Title: Study Design and Patients Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Procedures Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Statistical Analyses Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Changes in Renal Function Parameters Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Changes in Body Weight, Body Mass Index, and Waist Circumference Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Variation of Blood Pressure Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Changes in Glucose Metabolism Parameters and in RAS Components Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Independent Correlates of Repeated Measurements of Renal Parameters Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Appendix A Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Children: Item: Title: Angiotensin-Converting Enzyme (ACE2) Enzymatic Assay Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: ACE Enzymatic Assay Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: Appendix B Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4d3167f4 Info: Title: Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity Author: Anna Oliveras, Susana Vázquez, María José Soler, Isabel Galceran, Xavier Duran, Albert Goday, David Benaiges, Marta Crespo, Julio Pascual and Marta Riera Subject: 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. 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