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24.09.2018 | 2018 SAGES Oral | Ausgabe 5/2019

Surgical Endoscopy 5/2019

Long-term impact of bariatric surgery in diabetic nephropathy

Zeitschrift:
Surgical Endoscopy > Ausgabe 5/2019
Autoren:
LeAnne Young, Zubaidah Nor Hanipah, Stacy A. Brethauer, Philip R. Schauer, Ali Aminian
Wichtige Hinweise
This study was presented at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Seattle, April 2018.

Abstract

Background

Bariatric surgery has been shown to improve and resolve diabetes. However, limited literature about its impact on end-organ complications of diabetes is available. The aim of this study was to examine the long-term effect of bariatric surgery on albuminuria.

Methods

We studied 101 patients with pre-operative diabetes and albuminuria [defined as urine albumin:creatinine ratio (uACR) > 30 mg/g] who underwent bariatric surgery at an academic center from 2005 to 2014.

Results

Fifty-seven patients (56%) were female with a mean age of 53 (± 11) years. The mean pre-operative BMI and glycated hemoglobin (HbA1c) were 43.1 (± 7.6) kg/m2 and 8.4 (± 1.8)%, respectively. The median pre-operative uACR was 80.0 (45.0–231.0) mg/g. Bariatric procedures included Roux-en-Y gastric bypass (n = 75, 74%) and sleeve gastrectomy (n = 26, 26%). The mean follow-up period was 61 (± 29) months. At last follow-up, the mean BMI was 33.8 (± 8.3) kg/m2. The overall glycemic control improved after bariatric surgery. At last follow-up, 73% had good glycemic control (HbA1c < 7%) and 27% met diabetes remission criteria. The mean HbA1c at last follow-up was 6.7 (± 1.0)% and the median uACR was 30 (IQR 7–94) mg/g. Albuminuria improved in 77% and resolved in 51% of patients at long-term.

Conclusions

Bariatric surgery has a significantly positive impact on albuminuria in patients with obesity and type 2 diabetes. Our data showed almost an 80% improvement in albuminuria at the short- and long-term period after bariatric surgery.

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