Serra Assumpta, Esteve Anna, Navarro-Díaz Maruja, López Dolores, Bancu Ioana, Romero Ramón
Department of Nephrology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.
Obes Facts. 2015;8(3):188-99. doi: 10.1159/000431027. Epub 2015 May 8.
No long-term studies of renal function evolution in morbidly obese (MO) patients after weight loss are available. The aim of our work was to ascertain the long-term influence of drastic weight reduction on renal function in MO patients with obesity-related glomerular lesions.
92 MO patients with normal renal function and biopsy evidence of mild obesity-related glomerulopathy underwent bariatric surgery (BS) and subsequent drastic weight loss. A long-term prospective follow-up (mean duration: 76 ± 42 months) was carried out. Basal renal biopsies and basal and long-term metabolic and renal function studies were performed in all cases. Linear mixed models were applied.
Blood pressure dropped early after BS and remained stable thereafter. Creatinine clearance and BMI fell in the first 2 years, rose slightly after 5 years and then remained stable. Serum creatinine and albuminuria decreased throughout the follow-up period. Renal function and albuminuria evolution showed non-significant differences in relation to the number of glomerular lesions.
Drastic weight loss in BS-treated MO patients with pre-surgical normal renal function and mild obesity-related glomerular lesions is associated with short- and long-term maintenance of normal renal function and improvement in both arterial hypertension and albuminuria.
目前尚无关于病态肥胖（MO）患者体重减轻后肾功能演变的长期研究。我们这项工作的目的是确定大幅减重对患有肥胖相关肾小球病变的MO患者肾功能的长期影响。
92例肾功能正常且经活检证实患有轻度肥胖相关肾小球病的MO患者接受了减肥手术（BS）并随后大幅减重。进行了长期前瞻性随访（平均持续时间：76±42个月）。对所有病例均进行了基础肾活检以及基础和长期的代谢及肾功能研究。应用线性混合模型。
BS术后血压早期下降，此后保持稳定。肌酐清除率和体重指数在最初2年下降，5年后略有上升，然后保持稳定。血清肌酐和蛋白尿在整个随访期间均下降。肾功能和蛋白尿演变在与肾小球病变数量的关系上显示无显著差异。
接受BS治疗、术前肾功能正常且患有轻度肥胖相关肾小球病变的MO患者大幅减重与短期和长期维持正常肾功能以及改善动脉高血压和蛋白尿有关。
