Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity
Oliveras i Serrano, Anna (Hospital del Mar (Barcelona, Catalunya))
Vázquez, Susana (Institut Hospital del Mar d'Investigacions Mèdiques)
Soler, María José (Hospital Universitari Vall d'Hebron)
Galceran, Isabel (Institut Hospital del Mar d'Investigacions Mèdiques)
Duran-Jordà, Xavier (Institut Hospital del Mar d'Investigacions Mèdiques)
Goday Arnó, Albert (Universitat Autònoma de Barcelona. Departament de Medicina)
Benaiges, David (Universitat Autònoma de Barcelona. Departament de Medicina)
Crespo, Marta (Hospital del Mar (Barcelona, Catalunya))
Pascual, Julio (Institut Hospital del Mar d'Investigacions Mèdiques)
Riera Oliva, Marta (Hospital del Mar (Barcelona, Catalunya))
Universitat Autònoma de Barcelona

Data:	2022
Resum:	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.
Ajuts:	Ministerio de Economía y Competitividad RD16/0009/0013
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Bariatric surgery ; Hyperfiltration ; Albuminuria ; Renin-angiotensin axis ; Aldosterone ; Glucose metabolism
Publicat a:	Journal of clinical medicine, Vol. 11 (january 2022) , ISSN 2077-0383

DOI: 10.3390/jcm11030728
PMID: 35160179

12 p, 824.7 KB

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