Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
Department of Biostatistics, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
Surg Obes Relat Dis. 2017 Aug;13(8):1353-1360. doi: 10.1016/j.soard.2017.05.005. Epub 2017 May 4.
Bariatric surgery (BS) can improve glomerular hyperfiltration (GHPF). Very few studies identified associative factors with glomerular filtration rate and resolution from GHPF after BS.
To investigate the predictors of estimated GFR (eGFR) changes and resolution from GHPF after BS.
University hospital, Republic of Korea.
We enrolled patients who underwent BS for obesity from January 2008 to December 2014 and had more than a year of follow-up. GHPF was defined as an eGFR above 95th percentile values for age- and sex-matched cohorts extracted from the Korea National Health and Nutrition Examination Survey Database. Patients with baseline eGFR less than 60 mL/min/1.73 m were excluded.
A total of 138 patients (age interquartile range [IQR] 28-43; 21 men, 117 women) were analyzed. The median follow-up period was 36 months (IQR 25-45 mo). One hundred twenty patients (87%) were defined as having GHPF and 75 (54%) resolved after surgery. Multivariate analysis found that sex, preoperative body mass index (BMI), and age were predictive of postoperative eGFR. In patients with preoperative GHPF, female and lower BMI groups had significantly higher resolution rates (P = .012 for sex, P = .016 for BMI). Younger age was related with early resolution after BS.
Younger patients had a faster eGFR decline after BS. Predictive factors for resolution of GHPF after BS include female sex and lower BMI.
减重手术（BS）可改善肾小球高滤过（GHPF）。极少数研究确定了 BS 后与肾小球滤过率和 GHPF 缓解相关的因素。
研究预测 BS 后估算肾小球滤过率（eGFR）变化和 GHPF 缓解的因素。
韩国某大学医院。
我们纳入了 2008 年 1 月至 2014 年 12 月期间因肥胖接受 BS 的患者，且随访时间超过 1 年。GHPF 定义为 eGFR 高于从韩国国家健康和营养检查调查数据库中提取的年龄和性别匹配队列的第 95 百分位值。排除基线 eGFR 低于 60 mL/min/1.73 m 的患者。
共纳入 138 例患者（年龄中位数[IQR]28-43 岁；21 名男性，117 名女性）。中位随访时间为 36 个月（IQR 25-45 mo）。120 例（87%）患者被诊断为 GHPF，75 例（54%）患者术后缓解。多变量分析发现，性别、术前体重指数（BMI）和年龄是术后 eGFR 的预测因素。在术前存在 GHPF 的患者中，女性和较低 BMI 组的缓解率显著更高（性别 P =.012，BMI P =.016）。年轻患者与 BS 后早期缓解相关。
年轻患者 BS 后 eGFR 下降更快。BS 后 GHPF 缓解的预测因素包括女性和较低 BMI。
