Suppr超能文献

减重手术对慢性肾脏病风险的影响。

Effect of Bariatric Surgery on CKD Risk.

机构信息

Department of Medicine, Indiana University School of Medicine, Indianapolis Indiana;

Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.

出版信息

J Am Soc Nephrol. 2018 Apr;29(4):1289-1300. doi: 10.1681/ASN.2017060707. Epub 2018 Jan 15.

Abstract

Obesity is linked to the development and progression of CKD, but whether bariatric surgery protects against CKD is poorly understood. We, therefore, examined whether bariatric surgery influences CKD risk. The study included 2144 adults who underwent bariatric surgery from March of 2006 to April of 2009 and participated in the Longitudinal Assessment of Bariatric Surgery-2 Study cohort. The primary outcome was CKD risk categories as assessed by the Kidney Disease Improving Global Outcomes (KDIGO) consortium criteria using a combination of eGFR and albuminuria. Patients were 79% women and 87% white, with a median age of 46 years old. Improvements were observed in CKD risk at 1 and 7 years after surgery in patients with moderate baseline CKD risk (63% and 53%, respectively), high baseline risk (78% and 56%, respectively), and very high baseline risk (59% and 23%, respectively). The proportion of patients whose CKD risk worsened was ≤10%; five patients developed ESRD. Sensitivity analyses using year 1 as baseline to minimize the effect of weight loss on serum creatinine and differing eGFR equations offered qualitatively similar results. Treatment with bariatric surgery associated with an improvement in CKD risk categories in a large proportion of patients for up to 7 years, especially in those with moderate and high baseline risk. These findings support consideration of CKD risk in evaluation for bariatric surgery and further study of bariatric surgery as a treatment for high-risk obese patients with CKD.

摘要

肥胖与 CKD 的发生和进展有关,但减重手术是否能预防 CKD 仍知之甚少。因此,我们研究了减重手术是否会影响 CKD 的风险。该研究纳入了 2144 名于 2006 年 3 月至 2009 年 4 月期间接受减重手术且参与了纵向评估减重手术 2 研究队列的成年人。主要结局是根据肾脏病改善全球结局(KDIGO)协作组标准,采用 eGFR 和白蛋白尿的组合评估的 CKD 风险类别。患者中 79%为女性,87%为白人,中位年龄为 46 岁。在中危基线 CKD 风险(分别为 63%和 53%)、高危基线风险(分别为 78%和 56%)和极高危基线风险(分别为 59%和 23%)患者中,术后 1 年和 7 年观察到 CKD 风险改善。风险恶化的患者比例≤10%;5 名患者发展为 ESRD。使用基线为 1 年的敏感性分析,以尽量减少体重减轻对血清肌酐的影响和不同 eGFR 方程提供了定性相似的结果。在长达 7 年的时间里,减重手术治疗与 CKD 风险类别的改善相关,特别是在中危和高危基线风险的患者中。这些发现支持在评估减重手术时考虑 CKD 风险,并进一步研究减重手术作为治疗 CKD 高危肥胖患者的方法。

相似文献

1
Effect of Bariatric Surgery on CKD Risk.
J Am Soc Nephrol. 2018 Apr;29(4):1289-1300. doi: 10.1681/ASN.2017060707. Epub 2018 Jan 15.
2
The Association Between Kidney Disease and Diabetes Remission in Bariatric Surgery Patients With Type 2 Diabetes.
Am J Kidney Dis. 2019 Dec;74(6):761-770. doi: 10.1053/j.ajkd.2019.05.013. Epub 2019 Jul 19.
3
Estimated GFR Before and After Bariatric Surgery in CKD.
Am J Kidney Dis. 2017 Mar;69(3):380-388. doi: 10.1053/j.ajkd.2016.09.020. Epub 2016 Dec 4.
4
The measured glomerular filtration rate (mGFR) before and 6 months after bariatric surgery: A pilot study.
Nephrol Ther. 2017 May;13(3):160-167. doi: 10.1016/j.nephro.2016.10.002. Epub 2017 Feb 1.
5
Effect of weight loss on the estimated glomerular filtration rates of obese patients at risk of chronic kidney disease: the RIGOR-TMU study.
J Cachexia Sarcopenia Muscle. 2019 Aug;10(4):756-766. doi: 10.1002/jcsm.12423. Epub 2019 Apr 2.
7
Severe Chronic Kidney Disease Is Associated with a Lower Efficiency of Bariatric Surgery.
Obes Surg. 2019 May;29(5):1514-1520. doi: 10.1007/s11695-019-03703-z.
9
Association Between Obesity and Chronic Kidney Disease, Defined by Both Glomerular Filtration Rate and Albuminuria, in Korean Adults.
Metab Syndr Relat Disord. 2017 Oct;15(8):416-422. doi: 10.1089/met.2017.0053. Epub 2017 Aug 23.
10
Improved renal function 12 months after bariatric surgery.
Surg Obes Relat Dis. 2013 Mar-Apr;9(2):202-6. doi: 10.1016/j.soard.2012.10.005. Epub 2012 Oct 26.

引用本文的文献

2
Obesity and Metabolic Health in CKD.
Clin J Am Soc Nephrol. 2025 May 1;20(5):742-754. doi: 10.2215/CJN.0000000704. Epub 2025 Mar 14.
3
Obesity-Related Chronic Kidney Disease: From Diagnosis to Treatment.
Diagnostics (Basel). 2025 Jan 14;15(2):169. doi: 10.3390/diagnostics15020169.
4
Obesity-related renal dysfunction: gender-specific influence of visceral adiposity and early impact of metabolic and bariatric surgery.
Front Endocrinol (Lausanne). 2024 Oct 14;15:1440250. doi: 10.3389/fendo.2024.1440250. eCollection 2024.
5
Long-term systemic effects of metabolic bariatric surgery: A multidisciplinary perspective.
Heliyon. 2024 Jul 11;10(14):e34339. doi: 10.1016/j.heliyon.2024.e34339. eCollection 2024 Jul 30.
6
Bariatric surgery and the diseased kidney: a 5-year assessment of safety and postoperative renal outcomes.
Surg Endosc. 2024 Jul;38(7):4014-4023. doi: 10.1007/s00464-024-10983-9. Epub 2024 Jun 13.
7
Nutritional Challenges and Treatment After Bariatric Surgery.
Annu Rev Nutr. 2024 Aug;44(1):289-312. doi: 10.1146/annurev-nutr-061121-101547. Epub 2024 Aug 12.
8
The New Challenge of Obesity - Obesity-Associated Nephropathy.
Diabetes Metab Syndr Obes. 2024 May 6;17:1957-1971. doi: 10.2147/DMSO.S433649. eCollection 2024.
10
The impact of weight loss on renal function in individuals with obesity and type 2 diabetes: a comprehensive review.
Front Endocrinol (Lausanne). 2024 Jan 31;15:1320627. doi: 10.3389/fendo.2024.1320627. eCollection 2024.

本文引用的文献

1
Bariatric Surgery and Kidney-Related Outcomes.
Kidney Int Rep. 2017 Mar;2(2):261-270. doi: 10.1016/j.ekir.2017.01.010. Epub 2017 Jan 26.
2
Estimated GFR Before and After Bariatric Surgery in CKD.
Am J Kidney Dis. 2017 Mar;69(3):380-388. doi: 10.1053/j.ajkd.2016.09.020. Epub 2016 Dec 4.
3
Kidney outcomes three years after bariatric surgery in severely obese adolescents.
Kidney Int. 2017 Feb;91(2):451-458. doi: 10.1016/j.kint.2016.09.031. Epub 2016 Dec 1.
4
Effects of Bariatric Surgery on Renal Function in Obese Patients: A Systematic Review and Meta Analysis.
PLoS One. 2016 Oct 4;11(10):e0163907. doi: 10.1371/journal.pone.0163907. eCollection 2016.
5
Effect of Roux-en-Y gastric bypass and diet-induced weight loss on diabetic kidney disease in the Zucker diabetic fatty rat.
Surg Obes Relat Dis. 2017 Jan;13(1):21-27. doi: 10.1016/j.soard.2016.08.026. Epub 2016 Aug 18.
6
Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis.
Nat Rev Nephrol. 2016 Aug;12(8):453-71. doi: 10.1038/nrneph.2016.75. Epub 2016 Jun 6.
7
Bariatric surgery is associated with improvement in kidney outcomes.
Kidney Int. 2016 Jul;90(1):164-71. doi: 10.1016/j.kint.2016.02.039. Epub 2016 May 12.
8
Is Bariatric Surgery an Effective Treatment for Type II Diabetic Kidney Disease?
Clin J Am Soc Nephrol. 2016 Mar 7;11(3):528-35. doi: 10.2215/CJN.07670715. Epub 2015 Oct 8.
9
Long-term outcomes of bariatric surgery: a National Institutes of Health symposium.
JAMA Surg. 2014 Dec;149(12):1323-9. doi: 10.1001/jamasurg.2014.2440.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验