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Bariatric surgery benefits patients with diabetic nephropathy
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Patients with kidney disease resulting from diabetes saw improvement in their condition after undergoing bariatric surgery, according to new research presented at the Society of American Gastrointestinal and Endoscopic Surgeons 2018 Annual Meeting and World Congress of Endoscopic Surgery.
Ali Aminian, MD, of the Cleveland Clinic, and colleagues said there has been limited research on the impact of bariatric surgery on long-term organ complications related to diabetes, including diabetic nephropathy.
“Bariatric surgery significantly improves glycemic control in patients with type 2 diabetes,” Aminian told Healio Gastroenterology and Liver Disease. “The aim of this study was to assess the long-term renoprotective effects of bariatric surgery in patients with type 2 diabetes.”
Aminian and colleagues analyzed data from patients with diabetic nephropathy who underwent bariatric surgery at an academic center between 2005 and 2014 (n = 101). They diagnosed nephropathy in patients with urine albumin-to-creatinine ratios (uACR) greater than 30 mg/g (median preoperative uACR = 90 mg/g). Follow-up was at least a year after surgery. Researchers included patient demographics, perioperative data, pre- and post-operative weight, BMI, uACR and HbA1c in their analysis.
The data showed that the median change in uACR at the last follow-up was –44 mg/g (interquartile range –126 to 3). Additionally, 49 patients experienced resolution of albuminuria (49%) and 75 had overall uACR improvement (74%) by their last follow-up.
The investigators also found that the rate of glycemic control improved from a mean preoperative HbA1c of 8.5% ± 1.8, to 6.7% ± 1.5 at one year of follow-up and 6.8% ± 1.1 at the final follow-up.
“Findings of this study, which is the largest series of bariatric surgery in patients with diabetic nephropathy to date, showed a high resolution rate of albuminuria – in almost 50% of patients – in the intermediate to long-term postoperative follow up,” Aminian said. – by Alex Young
Reference:
Young L, et al. Abstract S038. Presented at: Society of American Gastrointestinal and Endoscopic Surgeons 2018 Annual Meeting and World Congress of Endoscopic Surgery; April 11-14; Seattle, WA.
Disclosures: The authors report no relevant financial disclosures.