Dewantoro Dickson, Fultang Joshua, Lowe Katie, Chinaka Ugochukwu, Bakhshi Andisheh, Ali Abdulmajid
Bariatric Surgery, University Hospital Ayr, Ayr, GBR.
Surgery, University of Glasgow, Glasgow, GBR.
Cureus. 2021 Oct 6;13(10):e18534. doi: 10.7759/cureus.18534. eCollection 2021 Oct.
Introduction Bariatric surgery offers superior benefits for weight loss, quality of life and a spectrum of metabolic diseases. Despite these benefits, studies so far have shown varying results on its effect on renal function. Aim In this study, we aim to look at bariatric surgery's effect on renal function at one, two and three year post operation (post-op). Methods This is a retrospective cross-sectional single-center study of patients who underwent bariatric surgery between 11/2008 and 06/2018. Renal function was calculated by using Cockroft-Gault equation, expressed as Creatinine Clearance (CrCl). Statistical analysis used was one-way ANOVA (Welch's) with Games-Howell Post-Hoc Test. Results From 307 patients who underwent bariatric surgery within the time period, 145 were studied. 30.3% (n=44) were male. The average age and body mass index (BMI) at referral were 48.1±8.6 years and 47.96±7.9 kgm respectively, while the average age and BMI at surgery were 49.1±8.8 years and 40.62±4.2 kgm respectively. Mean CrCl at surgery, year 1, year 2, and year 3 post-op were 172.35±53.29 mL/min, 179.20±57.87 mL/min, 142.35±46.05 mL/min, and 119.56±42.46 mL/min. Marginal improvement of CrCl at year one post-op (172.35±53.29mL/min to 179.20±57.87mL/min) was statistically insignificant (p=0.731). Meanwhile, there was statistically significant CrCl decline observed from year 1 to year 3 post-op (p<0.001). Conclusion Statistically insignificant marginal improvement in CrCl at year one post-op was noted. Beyond this, there was steady CrCl decline, albeit remained higher than the lower limit for respective gender. We recommend for further studies that take into account additional factors affecting renal function.
引言
减肥手术在减轻体重、改善生活质量以及治疗一系列代谢性疾病方面具有显著益处。尽管有这些好处,但迄今为止的研究表明,其对肾功能的影响结果各不相同。
目的
在本研究中,我们旨在观察减肥手术在术后1年、2年和3年对肾功能的影响。
方法
这是一项对2008年11月至2018年6月期间接受减肥手术的患者进行的回顾性横断面单中心研究。肾功能通过Cockcroft-Gault方程计算,以肌酐清除率(CrCl)表示。所使用的统计分析方法是采用Games-Howell事后检验的单因素方差分析(Welch检验)。
结果
在该时间段内接受减肥手术的307例患者中,对145例进行了研究。男性占30.3%(n = 44)。转诊时的平均年龄和体重指数(BMI)分别为48.1±8.6岁和47.96±7.9 kg/m²,而手术时的平均年龄和BMI分别为49.1±8.8岁和40.62±4.2 kg/m²。手术时、术后1年、2年和3年的平均CrCl分别为172.35±53.29 mL/min、179.20±57.87 mL/min、142.35±46.05 mL/min和119.56±42.46 mL/min。术后1年CrCl的轻微改善(从172.35±53.29 mL/min至179.20±57.87 mL/min)在统计学上无显著意义(p = 0.731)。同时,术后1年至3年观察到CrCl有统计学意义的下降(p<0.001)。
结论
术后1年CrCl有统计学意义的轻微改善并不明显。除此之外,CrCl呈稳步下降,尽管仍高于各性别下限。我们建议进一步开展研究,考虑影响肾功能的其他因素。