Five-year kidney outcomes of bariatric surgery differ in severely obese
adolescents and adults with and without type 2 diabetes.
Authors Bjornstad P, Nehus E, Jenkins T, Mitsnefes M, Moxey-Mims M, Dixon JB, Inge TH
Submitted By Petter Bjornstad on 8/11/2020
Status Published
Journal Kidney international
Year 2020
Date Published 5/1/2020
Volume : Pages 97 : 995 - 1005
PubMed Reference 32229096
Abstract Bariatric surgery improves markers of kidney health in severe obesity, yet it is
unclear if kidney disease outcomes differ according to age at surgery.
Therefore, we examined health effects of Roux-en-Y gastric bypass between 161
adolescents and 396 adults participating in two related but distinct studies.
Primary outcomes were elevated urine albumin-to-creatinine ratio (UACR) of 30
mg/g or more and hyperfiltration (an estimated glomerular filtration rate of 135
ml/min/1.73m2 or more). Analyses were stratified by the presence of
pre-operative type 2 diabetes. Adolescents with pre-operative type 2 diabetes
had a significantly increased prevalence of elevated UACR prior to surgery
compared to adults (22.5 vs. 9.0%). Resolution of elevated UACR following
surgery differed between adolescents and adults with type 2 diabetes, with
adolescents experiencing a significantly earlier improvement following surgery.
Adolescents without pre-operative type 2 diabetes demonstrated a significantly
increased prevalence of UACR prior to surgery compared to adults (9.4 vs. 4.5%),
with no improvement occurring in either group post-operatively. Adolescents with
pre-operative type 2 diabetes had a significantly increased prevalence of
hyperfiltration that remained throughout the study period, whereas
hyperfiltration prevalence was similar among those without type 2 diabetes.
Thus, adolescents with pre-operative type 2 diabetes experienced earlier
attenuation of elevated UACR compared to adults with pre-operative type 2
diabetes in response to gastric bypass.

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