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Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity

Obesity-related hyperfiltration leads to an increased glomerular filtration rate (GFR) and hyperalbuminuria. These changes are reversible after bariatric surgery (BS). We aimed to explore obesity-related renal changes post-BS and to seek potential mechanisms. Sixty-two individuals with severe obesit...

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Autores principales: Oliveras, Anna, Vázquez, Susana, Soler, María José, Galceran, Isabel, Duran, Xavier, Goday, Albert, Benaiges, David, Crespo, Marta, Pascual, Julio, Riera, Marta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837063/
https://www.ncbi.nlm.nih.gov/pubmed/35160179
http://dx.doi.org/10.3390/jcm11030728
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author Oliveras, Anna
Vázquez, Susana
Soler, María José
Galceran, Isabel
Duran, Xavier
Goday, Albert
Benaiges, David
Crespo, Marta
Pascual, Julio
Riera, Marta
author_facet Oliveras, Anna
Vázquez, Susana
Soler, María José
Galceran, Isabel
Duran, Xavier
Goday, Albert
Benaiges, David
Crespo, Marta
Pascual, Julio
Riera, Marta
author_sort Oliveras, Anna
collection PubMed
description Obesity-related hyperfiltration leads to an increased glomerular filtration rate (GFR) and hyperalbuminuria. These changes are reversible after bariatric surgery (BS). We aimed to explore obesity-related renal changes post-BS and to seek potential mechanisms. Sixty-two individuals with severe obesity were prospectively examined before and 3, 6 and 12 months post-BS. Anthropometric and laboratory data, 24 h-blood pressure, renin-angiotensin-aldosterone system (RAS) components, adipokines and inflammatory markers were determined. Both estimated GFR (eGFR) and albuminuria decreased from the baseline at all follow-up times (p-for-trend <0.001 for both). There was a median (IQR) of 30.5% (26.2–34.4) reduction in body weight. Plasma glucose, glycosylated hemoglobin, fasting insulin and HOMA-index decreased at 3, 6 and 12 months of follow-up (p-for-trend <0.001 for all). The plasma aldosterone concentration (median (IQR)) also decreased at 12 months (from 87.8 ng/dL (56.8; 154) to 65.4 (56.8; 84.6), p = 0.003). Both leptin and hs-CRP decreased (p < 0.001) and adiponectine levels increased at 12 months post-BS (p = 0.017). Linear mixed-models showed that body weight (coef. 0.62, 95% CI: 0.32 to 0.93, p < 0.001) and plasma aldosterone (coef. −0.07, 95% CI: −0.13 to −0.02, p = 0.005) were the independent variables for changes in eGFR. Conversely, glycosylated hemoglobin was the only independent variable for changes in albuminuria (coef. 0.24, 95% CI: 0.06 to 0.42, p = 0.009). In conclusion, body weight and aldosterone are the main factors that mediate eGFR changes in obesity and BS, while albuminuria is associated with glucose homeostasis.
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spelling pubmed-88370632022-02-12 Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity Oliveras, Anna Vázquez, Susana Soler, María José Galceran, Isabel Duran, Xavier Goday, Albert Benaiges, David Crespo, Marta Pascual, Julio Riera, Marta J Clin Med Article Obesity-related hyperfiltration leads to an increased glomerular filtration rate (GFR) and hyperalbuminuria. These changes are reversible after bariatric surgery (BS). We aimed to explore obesity-related renal changes post-BS and to seek potential mechanisms. Sixty-two individuals with severe obesity were prospectively examined before and 3, 6 and 12 months post-BS. Anthropometric and laboratory data, 24 h-blood pressure, renin-angiotensin-aldosterone system (RAS) components, adipokines and inflammatory markers were determined. Both estimated GFR (eGFR) and albuminuria decreased from the baseline at all follow-up times (p-for-trend <0.001 for both). There was a median (IQR) of 30.5% (26.2–34.4) reduction in body weight. Plasma glucose, glycosylated hemoglobin, fasting insulin and HOMA-index decreased at 3, 6 and 12 months of follow-up (p-for-trend <0.001 for all). The plasma aldosterone concentration (median (IQR)) also decreased at 12 months (from 87.8 ng/dL (56.8; 154) to 65.4 (56.8; 84.6), p = 0.003). Both leptin and hs-CRP decreased (p < 0.001) and adiponectine levels increased at 12 months post-BS (p = 0.017). Linear mixed-models showed that body weight (coef. 0.62, 95% CI: 0.32 to 0.93, p < 0.001) and plasma aldosterone (coef. −0.07, 95% CI: −0.13 to −0.02, p = 0.005) were the independent variables for changes in eGFR. Conversely, glycosylated hemoglobin was the only independent variable for changes in albuminuria (coef. 0.24, 95% CI: 0.06 to 0.42, p = 0.009). In conclusion, body weight and aldosterone are the main factors that mediate eGFR changes in obesity and BS, while albuminuria is associated with glucose homeostasis. MDPI 2022-01-29 /pmc/articles/PMC8837063/ /pubmed/35160179 http://dx.doi.org/10.3390/jcm11030728 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Oliveras, Anna
Vázquez, Susana
Soler, María José
Galceran, Isabel
Duran, Xavier
Goday, Albert
Benaiges, David
Crespo, Marta
Pascual, Julio
Riera, Marta
Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity
title Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity
title_full Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity
title_fullStr Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity
title_full_unstemmed Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity
title_short Exploring Renal Changes after Bariatric Surgery in Patients with Severe Obesity
title_sort exploring renal changes after bariatric surgery in patients with severe obesity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837063/
https://www.ncbi.nlm.nih.gov/pubmed/35160179
http://dx.doi.org/10.3390/jcm11030728
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