- After 24 months, Roux-en-Y gastric bypass (RYGB) was more effective than best medical treatment (BMT) for achieving remission of albuminuria and chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) and obesity.
Why this matters
- CKD contributes to early mortality in patients with T2D.
- Randomized, single-center trial of 100 patients with T2D, obesity, and microalbuminuria (urinary albumin-creatinine ratio [uACR] >30 mg/g and estimated glomerular filtration rate >30 mL/minute/1.73 m2) randomly assigned to BMT or RYGB.
- Funding: Johnson & Johnson Brasil; Oswaldo Cruz German Hospital; Science Foundation Ireland; Swedish Medical Research Council.
- After 24 months, albuminuria remission (uACR
- 55% of patients (95% CI, 39.0%-70.0%) after BMT vs
- 82% (95% CI, 72%-93%) after RYGB (P=.006).
- 23.6 in BMT vs
- 10.7 mg/g in RYGB (P<.001>
- 48.2% (95% CI, 32.2%-64.1%) with BMT vs
- 81.9% (95% CI, 71.8%-92.1%) with RYGB (P=.002).
- Short follow-up.
- Primary outcome based on single first-morning urine.
- Adverse events were heterogeneous.
- Results are expertise-dependent.