scholarly journals Bariatric Surgery Is Protective Against Renal Function Decline in Severely Obese Patients in the Long-Term

2020 ◽  
Author(s):  
Anne Lautenbach ◽  
Jan-Wilhelm Wienecke ◽  
Fabian Stoll ◽  
Nina Riedel ◽  
Oliver Mann ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Renal Function ◽  
Negative Correlation ◽  
Filtration Rate ◽  
Obese Patients ◽  
Renal Function Decline ◽  
Severely Obese ◽  
Age And Sex

Abstract Purpose This study aims to assess the long-term renal effects of bariatric surgery (BS) in severely obese patients over a follow-up period of up to 11 years. Materials and Methods In a retrospective cohort study including 102 patients, patients were stratified by eGFR at baseline and divided into three groups: (1) reduced, (2) normal, and (3) increased filtration rate. Adjustments for age- and sex-related decline in eGFR were performed. We used uni- and multivariate regression analysis to identify variables that were thought to determine change in eGFR. Results Over a median follow-up of 8.5 years (interquartile range 2.7), eGFR declined from 96.1 ± 20.7 to 84.9 ± 21.0 ml/min (p < 0.001). Among patients with (1), eGFR remained stable (69.1 ± 19.3 ml/min). Among patients with (2), eGFR declined from 99.7 ± 13.3 ml/min to 88.7 ± 19.4 ml/min (p < 0.001). Among patients with (3), eGFR decreased to normal levels (94.2 ± 17.7 ml/min, p < 0.001). Age- and sex-adjusted eGFR increased (6.4 ± 14.4 ml/min; p < 0.05) among patients with reduced filtration rate. Among patients with normal filtration rate, adjusted eGFR remained stable during follow-up (−1.3 ± 15.2 ml/min; n.s.). Among patients with increased filtration rate, adjusted eGFR decreased and remained within the normal range (−13.2 ± 12.2 ml/min; p < 0.001). Change in eGFR showed a negative correlation with eGFR at baseline (B = −0.31; p < 0.001), change in LDL-cholesterol (B = -0.09; p < 0.05), and a negative correlation with treatment requiring hypertension (B = -9.36; p = 0.001). Conclusion BS is protective against renal function decline in severely obese patients in the long term.

A historical cohort study of kidney damage in long-term lithium patients: continued surveillance needed

2001 ◽  
Vol 16 (4) ◽  
pp. 199-206 ◽  
Author(s):  
H. Bendz ◽  
M. Aurell ◽  
J. Lanke
Keyword(s):  
Renal Function ◽  
Treatment Duration ◽  
Filtration Rate ◽  
Lithium Treatment ◽  
Initial Study ◽  
Historical Cohort ◽  
Record Review ◽  
Insufficient Knowledge

SummaryBackgroundInsufficient knowledge on the longitudinal fate of renal function in lithium patients incited this retrospective study of 149 patients.MethodMedical record review of a lithium cohort (N = 149), 8–12 years after an initial renal function study.ResultsTwenty-one patients had died, one from uremia probably not caused by lithium, and 42 had discontinued lithium. Reduced urinary concentrating capacity (Umax) or glomerular filtration rate (GFR) was not more frequent among deceased or off-lithium patients than among the 86 patients who were on lithium at follow-up. In 63 of the latter patients, Umax had been re-examined after the initial study, and GFR in 29 patients. Reduced Umax and GFR had become twice as common, and average Umax and GFR had decreased significantly. The reduction of GFR was associated with lithium treatment duration and age, and reduced Umax with treatment duration only.ConclusionsReduced renal function is not a major cause of treatment discontinuation but becomes increasingly common with treatment duration.

scholarly journals Outcomes of Bariatric Surgery in Morbidly Obese Patients with Multiple Sclerosis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Kalman Bencsath ◽  
Adham Jammoul ◽  
Ali Aminian ◽  
Hideharu Shimizu ◽  
Carolyn J. Fisher ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Excess Weight ◽  
Control Group ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Percent Excess Weight Loss ◽  
Severely Obese

Obesity is common in patients with multiple sclerosis (MS); however, safety and efficacy of bariatric surgery in this population remain unclear. A database of 2,918 was retrospectively reviewed, yielding 22 (0.75%) severely obese patients with MS who underwent bariatric surgery. Sixteen surgical patients with complete follow-up data were matched to a nonsurgical control group of MS patients, based on age, BMI, MS subtype, and length of follow-up. MS relapse rates and trends in the timed twenty-five foot walk test (T25FW) were compared. In the surgical group (gastric bypass n=19, sleeve gastrectomy n=3), preoperative BMI was 46.5 ± 7.2 Kg/m2 and average excess weight was 60.4 kg. Follow-up data was collected at 59.0 ± 29.8 months. There were two major and four minor complications. Five patients required readmission and there were no mortalities. Percent excess weight loss was 75.5 ± 27.0%. In the 16 patients with follow-up data, patients who underwent bariatric surgery were significantly faster on the T25FW compared to the nonsurgical population. In conclusion, bariatric surgery is relatively safe and effective in achieving weight loss in patients with MS. In addition, surgery may help patients maintain ambulation. Findings support the need for further studies on bariatric surgery and disease-specific outcomes in this population.

scholarly journals Continued monitoring of acute kidney injury survivors might not be necessary in those regaining an estimated glomerular filtration rate >60 mL/min at 1 year

2017 ◽  
Vol 32 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Sokratis Stoumpos ◽  
Patrick B. Mark ◽  
Emily P. McQuarrie ◽  
Jamie P. Traynor ◽  
Colin C. Geddes
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Normal Renal Function ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Kidney Injury ◽  
Risk Of Progression

Background. Severe acute kidney injury (AKI) among hospitalized patients often necessitates initiation of short-term dialysis. Little is known about the long-term outcome of those who recover to normal renal function. The aim of this study was to determine the long-term renal outcome of patients experiencing AKI requiring dialysis secondary to hypoperfusion injury and/or sepsis who recovered to apparently normal renal function. Methods. All adult patients with AKI requiring dialysis in our centre between 1 January 1980 and 31 December 2010 were identified. We included patients who had estimated glomerular filtration rate (eGFR) >60 mL/min/1.73 m2 12 months or later after the episode of AKI. Patients were followed up until 3 March 2015. The primary outcome was time to chronic kidney disease (CKD) (defined as eGFR persistently <60 mL/min/1.73 m2) from first dialysis for AKI. Results. Among 2922 patients with a single episode of dialysis-requiring AKI, 396 patients met the study inclusion criteria. The mean age was 49.8 (standard deviation 16.5) years and median follow-up was 7.9 [interquartile range (IQR) 4.8–12.7] years. Thirty-five (8.8%) of the patients ultimately developed CKD after a median of 5.3 (IQR 2.8–8.0) years from first dialysis for AKI giving an incidence rate of 1 per 100 person-years. Increasing age, diabetes and vascular disease were associated with higher risk of progression to CKD [adjusted hazard ratios (95% confidence interval): 1.06 (1.03, 1.09), 3.05 (1.41, 6.57) and 3.56 (1.80, 7.03), respectively]. Conclusions. Recovery from AKI necessitating in-hospital dialysis was associated with a very low risk of progression to CKD. Most of the patients who progressed to CKD had concurrent medical conditions meriting monitoring of renal function. Therefore, it seems unlikely that regular follow-up of renal function is beneficial in patients who recover to eGFR >60 mL/min/1.73 m2 by 12 months after an episode of AKI.

Prognostic Value of Negative Coronary CT Angiography in Severely Obese Patients Prior to Bariatric Surgery: a Follow-Up After 6 Years

2017 ◽  
Vol 27 (8) ◽  
pp. 2044-2049 ◽  
Author(s):  
Michael Messerli ◽  
Céline Maywald ◽  
Stephan Wälti ◽  
René Warschkow ◽  
Simon Wildermuth ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Ct Angiography ◽  
Prognostic Value ◽  
Coronary Ct Angiography ◽  
Obese Patients ◽  
Coronary Ct ◽  
Severely Obese

scholarly journals Effect of Drastic Weight Loss after Bariatric Surgery on Renal Parameters in Extremely Obese Patients: Long-Term Follow-Up

2006 ◽  
Vol 17 (12 suppl 3) ◽  
pp. S213-S217 ◽  
Author(s):  
Maruja Navarro-Díaz ◽  
Assumpta Serra ◽  
Ramón Romero ◽  
Josep Bonet ◽  
Beatriu Bayés ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Obese Patients ◽  
Long Term Follow Up

scholarly journals Renal function in patients receiving long-term warfarin therapy: A five-year prospective follow-up

2017 ◽  
Vol 89 (9) ◽  
pp. 78-86 ◽  
Author(s):  
O A Zemlyanskaya ◽  
E S Kropacheva ◽  
A B Dobrovolsky ◽  
E P Panchenko
Keyword(s):  
Renal Function ◽  
Prognostic Value ◽  
Filtration Rate ◽  
Warfarin Therapy ◽  
Vitamin K Antagonists ◽  
Antiplatelet Agents ◽  
International Normalized Ratio ◽  
Estimate Glomerular Filtration Rate

Aim. To investigate the prognostic value of renal function and to estimate glomerular filtration rate (GFR) changes during a 5-year follow-up of patients receiving warfarin therapy. Subjects and methods. 200 patients (124 men, 76 women) mainly from a group at high risk for thromboembolic events (mean CHA2DS2-VASc scores, 3.25±1.89) were examined. The patients’ mean age was 62.3±9.4 years; the follow-up period was 5 years. 74% of the patients received warfarin monotherapy (international normalized ratio (INR) 2.0 to 3.0); 36% took vitamin K antagonists in combination with one or two antiplatelet agents. The CKD-EPI formula was used to estimate GFR in all the patients at baseline and throughout the investigation once a year. Results. GFR less than 70.9 ml/min/1.73 m2 was found to be a predictor of fatal and nonfatal thrombotic events. The decreased GFR was unassociated with the development of major and clinically relevant hemorrhagic complications within 5 years of warfarin therapy. The initial decline in renal function (GFR

Early Renal Dysfunction in Obese Patients with Insulin Resistance

2019 ◽  
Vol 26 (3) ◽  
pp. 261-265
Author(s):  
Natalia Pertseva ◽  
Mariia Rokutova
Keyword(s):  
Insulin Resistance ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Filtration Rate ◽  
Diagnostic Value ◽  
Glomerular Hyperfiltration ◽  
Model Assessment ◽  
Homa Index ◽  
Obese Patients ◽  
Homeostasis Model Assessment

Abstract Background and aims. Obese individuals have insulin resistance status assessed in the present study by the HOMA index (“Homeostasis model assessment”). This prospective study assessed renal disorders in the insulin resistance in obese patients. Material and Methods. The study included 73 young obese patients. The assessment included the HOMA index before meal and parameters of renal function (glomerular filtration rate, albuminuria, β2-microglobulinuria). Results. In young obese, insulin-resistance patients, glomerular hyperfiltration and β2-microglobulinuria are found in 77.0 and 93.4% of cases respectively. The albuminuria is noted in some cases, which reduces diagnostic value. Conclusions. In young obese patients with insulin resistance, glomerular hyperfiltration and β2-microglobulinuria are main diagnostic markers of renal dysfunction.

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