Effectiveness and Safety of Bariatric Surgery in Patients with End‐Stage Chronic Kidney Disease or Kidney Transplant

Jessica Guggino; Sandrine Coumes; Nelly Wion; Fabian Reche; Catherine Arvieux; Anne‐Laure Borel

doi:10.1002/oby.23001

journal article Nov 24, 2020

Effectiveness and Safety of Bariatric Surgery in Patients with End‐Stage Chronic Kidney Disease or Kidney Transplant

Jessica Guggino Sandrine Coumes Nelly Wion Fabian Reche Catherine Arvieux Anne‐Laure Borel

Obesity Vol. 28 No. 12 pp. 2290-2304 · Wiley

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Abstract

ObjectiveThis study aimed to evaluate (1) the effectiveness, complications, and postoperative access to transplantation in end‐stage chronic kidney disease (ECKD) and (2) the effectiveness and complications of bariatric surgery in patients who had already undergone kidney transplant.MethodsA systematic review and meta‐analysis of mortality and complications rates were performed. Thirty studies were reviewed.ResultsAfter bariatric surgery, patients with ECKD had similar postoperative weight loss to patients from the general population. Meta‐analysis showed post–bariatric surgery rates of 2% (95% CI: 0%‐3%) for mortality and 7% (95% CI: 2%‐14%) for complications. Approximately one‐fifth of the patients had access to a transplant. This rate may be underestimated because of the short duration of follow‐up. The lack of control groups did not allow for a conclusion on the role of bariatric surgery in facilitating access to kidney transplantation. In patients who had received a kidney transplant, bariatric surgery seemed to improve renal function but increased graft‐rejection risk, possibly because of changes in the bioavailability of immunosuppressant drugs.ConclusionsBariatric surgery yields significant weight loss in patients with ECKD that improves patients’ chances of accessing a transplant but does not guarantee it; however, the risk for complications and death is higher than in other patients. After transplantation, bariatric surgery‐induced weight loss appeared to positively impact the function of the grafted kidney, but careful monitoring of immunosuppressant medications is required.

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Metrics

22

Citations

56

References

Details

Published: Nov 24, 2020
Vol/Issue: 28(12)
Pages: 2290-2304
License: View

Authors

J

Jessica Guggino

Endocrinology, Diabetology, Nutrition Grenoble Alpes University Hospital Grenoble France

S

Sandrine Coumes

Endocrinology, Diabetology, Nutrition Grenoble Alpes University Hospital Grenoble France

N

Nelly Wion

Endocrinology, Diabetology, Nutrition Grenoble Alpes University Hospital Grenoble France

F

Fabian Reche

Digestive Surgery Grenoble Alpes University Hospital Grenoble France; CNRS UMR 5525 TIMC‐IMAG Domaine de la Merci Grenoble France

C

Catherine Arvieux

Digestive Surgery Grenoble Alpes University Hospital Grenoble France

A

Anne‐Laure Borel

Endocrinology, Diabetology, Nutrition Grenoble Alpes University Hospital Grenoble France; Hypoxia Pathophysiology (HP2) INSERM U1042 Grenoble Alpes University Grenoble France

Funding

Agir pour les Maladies Chroniques

Cite This Article

Jessica Guggino, Sandrine Coumes, Nelly Wion, et al. (2020). Effectiveness and Safety of Bariatric Surgery in Patients with End‐Stage Chronic Kidney Disease or Kidney Transplant. Obesity, 28(12), 2290-2304. https://doi.org/10.1002/oby.23001

Effectiveness and Safety of Bariatric Surgery in Patients with End‐Stage Chronic Kidney Disease or Kidney Transplant

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