ODP002 ASSOCIATION BETWEEN OBESITY AND DIABETES POTENTIATES RENAL FUNCTION IMPAIRMENT IN BARIATRIC PATIENTS

: Obesity may impair renal function directly or through comorbidities and complications, such as Diabetes Mellitus (DM), hypertension, and dyslipidemia. AIM: To evaluate renal function in obese patients before treatment with bariatric surgery. MATERIAL & METHODS: Serum creatinine was evaluated pre-operatively in 68 obese patients referred to treatment with sleeve gastroplasty. Glomerular filtration rate (eGFR) was estimated through the CKD-EPI Creatinine 2009 Equation. Data on prevalence and occasionally treatment of DM and hypertension were obtained and an additional biochemical work-up (hbA1c, lipid profile, vitamin D) was performed. RESULTS: Fifty-one subjects had class III obesity (75%) and 17 were classified as class II with metabolic or locomotor complications (25%). Most patients were women (70.6%), had hypertension (66.2%) and low vitamin D (85.9%) and HDL (52.9%) levels. Mean age was 37.8± 8.6 years and mean BMI 43.43± 5.72 kg/m(2). The prevalence of DM was 47.6%. While 47.1% of the patients were using renin–angiotensin–aldosterone system inhibitors, only a few were using reno-protective antidiabetic drugs (4.4% on SGLT2 inhibitors and 1.5% on GLP1 agonists). Mean serum creatinine was 0.8± 0.2 mg/dL and eGFR, 100.9± 18. 0 mL/min/1.73m(2) (26.5% of patients had eGFR below 90 and 1.5%, values above 130 mL/min/1.73m(2)). Mean HbA1c was 5.9±0.8% (DM: 6.4±0.9%, non-diabetics: 5.4±0.2%, p < 0. 0001) and HbA1c was above 6.5% in 16.9% of the patients. Mean LDL, HDL, and triglycerides were, respectively, 121.2± 29.9, 47.1± 10.2, and 148.4± 64.6 mg/mL and mean 25OH vitamin D was 22.6± 8. 0 ng/mL. Creatinine levels of patients with class II and III obesity were similar (0.8± 0.1 vs. 0.8± 0.2 mg/dL, respectively, p = 0.3273) and there was no significant difference when eGFR of these two groups was compared (100.9± 15.5 vs. 100.9± 18.8 mL/min/1.73m(2), respectively, p = 1. 0000). Patients with DM had higher creatinine levels (0.9± 0.2 vs. 0.8± 0.1 mg/dL, p = 0. 0154) and lower eGFR (96.3 ± 18.3 vs. 105. 0 ± 16.9mL/min/1.73m(2), p = 0. 0439) than non-diabetics. Linear regression models indicated statistically significant associations between creatinine and eGFR and the presence of DM (p = 0. 0154 and 0. 0439, respectively). No association involving creatinine or eGFR and presence of hypertension, or levels of BMI, LDL, HDL, triglycerides, vitamin D or HbA1c was detected. CONCLUSION: The study points to the importance of pre-operative renal function screening in bariatric patients, since more than a quarter of the subjects had a decrease in glomerular filtration before surgery at a relatively young age. Although no association between long-term glucose control, represented by HbA1c, and renal function was detected, obese patients with DM seem to be at higher risk for precocious renal function impairment. Presentation: No date and time listed