Bariatric surgery is linked to reduced kidney, heart risk in insulin-treated T2D

  • Alkharaiji M & al.
  • Obes Surg
  • 4 Mar 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Bariatric surgery may protect patients with type 2 diabetes (T2D) with or without microalbuminuria against risks for chronic kidney disease (CKD) and nonfatal cardiovascular disease (CVD).
  • It also may modestly improve estimated glomerular filtration rate (eGFR).

Why this matters

  • T2D increases risks for CVD and CKD.

Study design

  • Retrospective cohort study of insulin-treated patients with T2D from The Health Improvement Network database (UK) with propensity score matching of 131 patients who underwent bariatric surgery with 579 who did not, followed for 12.8 years.
  • Funding: None disclosed.

Key results

  • In matched cohort, the bariatric surgery group had significantly lower risk for developing CKD than did the nonbariatric group (adjusted HR [aHR], 0.46; P=.013).
  • Protective CKD effect also seen among those with baseline microalbuminuria (aHR, 0.42; P=.050), but nonsignificant effect against developing CVD (aHR, 0.36; P=.079).
  • Compared with a mean baseline eGFR 68.7 and 70.8 mL/minute/1.73 m2 in bariatric and nonbariatric groups, respectively, mean eGFR did not differ between groups in the first 3 years.
  • However, it was significantly improved in the bariatric vs nonbariatric group at 4 years (72.9 vs 66.8 mL/minute/1.73 m2; P=.001).
  • Serum creatinine at 2 years was 77.2 μmol/L in the bariatric vs 90.5 μmol/L in the nonbariatric group (P=.008).

Limitations

  • Changes in medication, glycemia, or BP not evaluated.