Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.
Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung, Taiwan.
Obes Surg. 2019 Aug;29(8):2527-2534. doi: 10.1007/s11695-019-03869-6.
Preoperative anemia is a risk factor for acute kidney failure after high-risk surgeries. We assessed the impact of preoperative anemia on kidney function in an obese Asian population after laparoscopic bariatric surgery.
Patient characteristics, comorbidities, type of surgery, perioperative profiles, eGFR, and micronutrition were retrospectively reviewed in 341 patients with obesity undergoing bariatric surgery. All patients, who had a preoperative estimated glomerular filtration rates (eGFR) ≥ 90 mL/min/1.73 m, were followed for 1 year and assigned to one of two groups: anemia or non-anemia group. Preoperative anemia was determined based on hemoglobin concentration.
The Pearson's correlation coefficient between preoperative body mass index (BMI) and preoperative eGFR of all patients was 0.169 (p = 0.005). Preoperatively, there were no significant differences in age, BMI, and eGFR between the anemia (n = 38) and non-anemia groups (n = 303). Patients in the anemia group had lower hemoglobin concentration at baseline, 1 month, and 12 months after surgery than those in the non-anemia group. Postoperative eGFR levels at 1 month (p = 0.993) and 1 year (p = 0.118) as well as hospital stay (p = 0.941) were comparable between the two groups. However, the percentage weight loss was significantly higher in the non-anemia group than that in the anemia group 1 year after bariatric surgery (30.0 ± 7.3% vs. 27.0 ± 8.1%; p = 0.041).
Preoperative anemia did not negatively impact kidney function following laparoscopic bariatric surgery during the 12-month follow-up. Considering the potential adverse impact of anemia on postoperative weight loss, preoperative correction of anemia may be recommended.
术前贫血是高危手术后急性肾衰竭的危险因素。我们评估了术前贫血对腹腔镜减重手术后肥胖亚洲人群肾功能的影响。
回顾性分析了 341 例接受减重手术的肥胖患者的患者特征、合并症、手术类型、围手术期情况、eGFR 和微量营养素。所有患者术前估算肾小球滤过率（eGFR）≥90 mL/min/1.73 m，随访 1 年，并分为两组：贫血组或非贫血组。根据血红蛋白浓度确定术前贫血。
所有患者术前体重指数（BMI）与术前 eGFR 的 Pearson 相关系数为 0.169（p=0.005）。贫血组（n=38）和非贫血组（n=303）患者术前年龄、BMI 和 eGFR 无显著差异。贫血组患者基线、术后 1 个月和 12 个月的血红蛋白浓度均低于非贫血组。两组患者术后 1 个月（p=0.993）和 1 年（p=0.118）eGFR 水平及住院时间（p=0.941）相当。然而，减重手术后 1 年，非贫血组的体重减轻百分比明显高于贫血组（30.0±7.3% vs. 27.0±8.1%；p=0.041）。
在 12 个月的随访中，术前贫血对腹腔镜减重手术后的肾功能没有负面影响。考虑到贫血对术后减重的潜在不良影响，术前纠正贫血可能是必要的。
