Surgical Center for Obesity and Diabetes, Jinshazhou Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510515, China.
UDM Medical Group, Guangzhou, 510515, China.
Obes Surg. 2021 Oct;31(10):4470-4484. doi: 10.1007/s11695-021-05630-4. Epub 2021 Aug 6.
BACKGROUND/OBJECTIVE: The effect of bariatric surgery in renal function varies and the postoperative benefit time point remains unclear. We aim to assess the changes of renal function after bariatric surgery (BS) in different postoperative periods and subgroups.
We searched the databases of PubMed and Cochrane from inception to December 14, 2020. Articles included in the study were drawn from all recipients of BS that provided assessments of renal function pre and post-surgery. Meta-analysis was performed to compare glomerular filtration rate (GFR), serum creatinine, albumin-to-creatinine ratio (ACR), and albuminuria before and after BS.
The study included 49 articles involving 8515 patients. Compared with pre-operative renal function, the overall analysis showed that bariatric surgery significantly reduced serum creatinine levels, ACR, and albuminuria. There was significant increase of GFR in the CKD subgroup, yet a noticeable decrease in the hyperfiltration subgroup. The most significant improvement in GFR was seen 6-12 months after BS, while ACR dropped most dramatically 12-24 months after BS.
Bariatric surgery can improve renal function in obese patients with kidney dysfunction, especially 1 year after surgery.
背景/目的：减重手术对肾功能的影响各不相同，术后获益的时间点仍不清楚。我们旨在评估不同术后时期和亚组的减重手术后肾功能的变化。
我们从 2020 年 12 月 14 日起检索了 PubMed 和 Cochrane 数据库。研究中纳入的文章均来自接受过减重手术的患者，这些患者提供了手术前后肾功能的评估。对肾小球滤过率（GFR）、血清肌酐、白蛋白与肌酐比值（ACR）和蛋白尿在减重手术前后的变化进行了荟萃分析。
该研究纳入了 49 篇文章，涉及 8515 名患者。与术前肾功能相比，总体分析显示减重手术显著降低了血清肌酐水平、ACR 和蛋白尿。在 CKD 亚组中，GFR 有显著增加，而在高滤过亚组中则有显著下降。BS 后 6-12 个月 GFR 改善最明显，而 BS 后 12-24 个月 ACR 下降最明显。
减重手术可以改善肥胖伴肾功能障碍患者的肾功能，尤其是在术后 1 年。
