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减肥手术可改善肥胖患者的肾功能。

Bariatric Surgery Improves Renal Function in Patients With Obesity.

作者信息

Abernathy Oaklee L, Okut Hayrettin, Paull-Forney Bobbie G, Schwasinger-Schmidt Tiffany E

机构信息

Internal Medicine, Kansas University School of Medicine-Wichita, Wichita, USA.

Preventive Medicine, Kansas University School of Medicine-Wichita, Wichita, USA.

出版信息

Cureus. 2021 Aug 26;13(8):e17458. doi: 10.7759/cureus.17458. eCollection 2021 Aug.

Abstract

Background Obesity affects 93.3 million adults in the United States and is a predisposing factor for the development and progression of chronic kidney disease (CKD). The objective of this study is to examine the association between weight loss and renal function in participants undergoing bariatric surgery following a 12-week multidisciplinary, community-based weight loss program. Methodology This is a retrospective chart review of participants who voluntarily enrolled in a 12-week multidisciplinary weight loss program prior to bariatric surgery from 2009 to 2018. The primary outcome was to assess the association between weight loss and renal function in participants undergoing bariatric surgery. Secondary outcomes included changes in hemoglobin A1c, lipids, fasting glucose, and blood pressure. Results Among the 55 participants, baseline glomerular filtration rate (GFR) was 49 mL/min/m, 80% were female, and the average baseline weight was 131 kg. At one-year post-intervention, 69% of patients improved in the CKD stage, with 45% of the participants improving from stage 3A to stage 2. GFR improved to 15 mL/min/1.73m (p = 0.025), and there was a negative correlation (r = -0.3556) between weight and GFR (p = 0.013). Participants with hyperlipidemia had a 12 mL/min/1.73m rise in GFR, while participants without the diagnosis at one year had a 24 mL/min/1.73m rise in GFR (p = 0.007). Conclusions This study demonstrated improved renal function and reduced progression of CKD following a combined lifestyle and surgical intervention, indicating the importance of a comprehensive approach for the management of the chronic disease.

摘要

背景

肥胖影响着美国9330万成年人,是慢性肾脏病(CKD)发生和进展的一个诱发因素。本研究的目的是在参与者接受为期12周的多学科、基于社区的减肥计划后,研究减肥与肾功能之间的关联,这些参与者随后接受了减肥手术。方法:这是一项对2009年至2018年在减肥手术前自愿参加为期12周多学科减肥计划的参与者的回顾性图表审查。主要结果是评估接受减肥手术的参与者中减肥与肾功能之间的关联。次要结果包括糖化血红蛋白、血脂、空腹血糖和血压的变化。结果:在55名参与者中,基线肾小球滤过率(GFR)为49 mL/min/m²,80%为女性,平均基线体重为131 kg。干预后一年,69%的患者CKD分期得到改善,45%的参与者从3A期改善到2期。GFR提高到15 mL/min/1.73m²(p = 0.025),体重与GFR之间存在负相关(r = -0.3556)(p = 0.013)。高脂血症参与者的GFR升高了12 mL/min/1.73m²,而一年时未诊断出该病的参与者GFR升高了24 mL/min/1.73m²(p = 0.007)。结论:本研究表明,综合生活方式和手术干预后肾功能得到改善,CKD进展减缓,这表明综合方法对该慢性病管理的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7da/8475746/8d7525b5cf4c/cureus-0013-00000017458-i01.jpg

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