The Impact of Renal Function on Outcomes of Bariatric Surgery. *Center for the Study of Nutrition Medicine and. †Center for the Study of Nutrition Medicine, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Blackburn, Department of Surgery, Center for the Study of Nutrition Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215. 1 offer new insights into the relationship between complications from bariatric surgery and kidney function measured by GFR.
Oxalate nephropathy: An important cause of renal failure after bariatric surgery. We report a 54-year-old male patient who presented with progressive worsening of renal function following a duodenal switch procedure for morbid obesity, and he was found to have oxalate nephropathy on renal biopsy. Oxalate nephropathy has many etiologies and remains a rare cause of renal failure. It is characterized by tubular crystalline deposits of calcium oxalate leading to acute and chronic tubular injury, interstitial fibrosis, and progressive renal insufficiency. His serum creatinine was 1.38 mg/dl and urinalysis was normal at the time of surgery. A diagnosis of oxalate nephropathy secondary to enteric hyperoxaluria post-duodenal switch operation was made and he was started on low-oxalate, low-fat diet, with high-fluid intake (> 3 liters per day). We report a case of oxalate nephropathy occurring in the second-year post-duodenal switch surgery for morbid obesity. With increasing numbers of RYGB and duodenal switch operations being performed, the complication of oxalate nephropathy is coming to light. Oxalate nephropathy is progressive in nature and has a poor prognosis.[ 6 , 7 ] Measured 24-h urinary collections in 45 patients after bariatric surgery over 2 years[ 6 ] and reported that bariatric surgery was almost uniformly associated with increased urinary oxalate and calcium oxalate super saturation. Other important potential factors contributing to nephrolithiasis in this population were decreased urinary volume and decreased urinary citrate.[ 6 ] In a large group of 4,639 RYGB patients, the incidence of nephrolithiasis was 7.7% compared with an incidence of 4.6% in an equally large control group of obese patients who had not undergone an operation.[ 7 ] Until now, only a few case reports of oxalate nephropathy have been reported after bariatric surgery. Have reported the largest series of oxalate nephropathy with 11 cases diagnosed post-RYGB of which eight reached ESRD.[ 10 ] The diagnosis of oxalate nephropathy should be suspected in any patient who presents with sub-acute or chronic renal failure following bariatric surgery. Though bariatric surgeries have significant benefits in terms of mortality and morbidity, it is important that the clinician be aware of post-procedure risk of developing secondary enteric hyperoxaluria, nephrolithiasis, and renal failure due to oxalate nephropathy.
This article evaluated the likelihood of being diagnosed with or treated for an upper urinary tract calculus after gastric banding. However, the kidney stone risk of gastric banding, a restrictive bariatric procedure, is unknown. After gastric banding, the diagnosis of an upper urinary tract calculus occurred in 3 subjects (1.49%), as compared with 12 subjects (5.97%) in the comparison cohort (P = .0179). Gastric banding is not associated with an increased risk for kidney stone disease or kidney stone surgery in the postoperative period. Gastric Band Placement for Obesity Is Not Associated With Increased Urinary Risk of Urolithiasis Compared With Bypass. A comparison of urinary risk of urolithiasis after the Roux-en-Y and gastric banding procedures was performed. Mean time since surgery was 3.4 and 2.1 years for the Roux-en-Y gastric bypass and gastric-banding groups, respectively. Urinary calcium excretion was lower (P = .001) in the Rouxen-Y gastric bypass (100 mg daily) versus the gastricbanding group (191 mg daily). After Roux-en-Y gastric bypass surgery, 48% had a urinary oxalate of 45 mg daily or more compared with 25% after gastric banding. Urinary citrate was less than 370 mg daily for 14 subjects in the Roux-en-Y gastric bypass and for 1 subject in the gastric banding group. The study confirmed the risk of urinary stones following the Roux-en-Y gastric bypass procedure as a result of hyperoxaluria, low urine volume, and hypocitraturia.
Surgical Weight Loss Procedures for Kidney Transplant Patients. Surgery to Achieve Weight Loss and Qualify for a Kidney Transplant. Some overweight patients who wish to have a kidney transplant are able to lose weight through diet and exercise in order to qualify for a transplant. The Bariatric Surgery Center at UCSF Medical Center can help patients lose weight and maintain that weight loss to improve overall health. In the case of patients waiting for a kidney transplant, losing weight also can improve their chances of being a transplant candidate. The procedure being performed most commonly at UCSF is the gastric bypass, which has been shown to be the most effective way for morbidly obese patients to lose weight. The surgeon performing this procedure in patients with kidney failure or in patients with transplants is also a transplant surgeon who is familiar with the special needs of these patients. Over the past few years, we have examined the potential benefits of gastric bypass procedures in morbidly obese dialysis and transplant patients and found that this surgery can be performed safely and may be a life–saving procedure. Patients with end-stage renal disease who require dialysis need an easy-to-use entryway or "access" to the bloodstream for regular dialysis treatments to take place. The graft can be used for dialysis access a few weeks after it is created. This allows for faster healing, and earlier use of the catheter.
The rate of kidney failure for general and vascular surgery patients is expressed as an odds ratio. A number of 1.0 means the hospital is performing as expected. A number less than 1.0 means the hospital is performing better than expected. A number greater than 1.0 means the hospital is performing worse than expected. Note: While Northwestern Memorial results may be higher or lower than ACS NSQIP comparisons each period, our most recent performance is considered by ACS NSQIP to be "as expected" within the range expected for this surgical outcome. Given the number of patients in the measure, the results are statistically the same.
People who are unable to lose weight through modifications of diet and exercise may consider bariatric (weight loss) surgery. Bariatric surgery is a major operation that can cause significant side effects, including vitamin deficiencies, blood clots and infections that may be life-threatening. Hair loss is a side effect of bariatric surgery caused by decreases in the amount of protein consumption. Dumping syndrome is a side effect of bariatric surgery caused by the stomach emptying too quickly, and causes symptoms of nausea, vomiting, diarrhea and abdominal cramps. Blood clots in the legs are a life-threatening side effect of bariatric surgery, and are more likely to occur in severely obese patients. Kidney stones and gallstones are side effects of bariatric surgery that may cause intense pain and serious infections if not treated.
These medical, or co-morbid, conditions include type 2 diabetes, heart disease and high blood pressure, acid reflux/GERD, and cancer. You may want to compare bariatric surgery's high resolution rates for type 2 diabetes to the long-term effects of the condition. Heart Disease and High Blood Pressure. Long-term Complications of Heart Disease and High Blood Pressure. Heart disease and high blood pressure are related health conditions. Heart disease is an umbrella term for several diseases that affect the heart and the circulatory system. You may want to compare bariatric surgery's high resolution rates for heart disease to the long-term effects of these conditions. People living with morbid obesity are at risk for developing heart disease and high blood pressure, including conditions such as: Heart disease including hardening of the arteries (atherosclerosis), which is a principle cause of coronary heart disease, and heart attack. Stomach acid splashes up into the esophagus, which can damage it and lead to painful conditions and cancer. Barrett's esophagus which occurs because the lining of the esophagus is damaged by stomach acid and can lead to esophageal cancer. Morbid Obesity and Cancer Risks. You may want to consider bariatric surgery's resolution rates for osteoarthritis and the long-term effects of the condition. Heart disease, including hardening of the arteries, which can lead to heart attacks and stroke.
Risk factors and outcomes of acute kidney injury (AKI) after gastric bypass surgery are not well understood, however. A total of 504 patients underwent gastric bypass between January 2003 and 2005. By multivariable analyses, the independent risk factors for AKI were body mass index (odds ratio [OR] 1.03; 95% confidence interval [CI] 1.00 to 1.06), hyperlipidemia (OR 2.53; 95% CI 1.21 to 5.28), and preoperative use of ACE-I or ARB (OR 2.06; 95% CI 1.05 to 4.04). Postoperative AKI is not infrequent after gastric bypass surgery. Certain comorbid conditions and their commonly prescribed treatments, ACE-I or ARB, are independently associated with increased risk for postoperative AKI. The risk factors for acute kidney injury (AKI) and consequences of AKI on patient outcomes in the setting of gastric bypass surgery are not well understood. Of all of the cases of AKI, fewer than half occur in surgical settings, and only 10 to 15% of cases occur in the setting of noncardiovascular surgery. Depending on the degree of renal injury and the type of surgery, acute renal failure increases hospital mortality (e.g., in high-risk surgeries such as cardiac surgery, postoperative mortality in severe AKI can be > 50%) ( 8 ). We hypothesized that comorbid conditions or their treatment may influence the risk for postoperative AKI in morbidly obese patients who undergo gastric bypass surgery. In an observational cohort study, we aimed to (1) examine the incidence of AKI; (2) identify risk factors of AKI; and (3) examine the effects of AKI on short-term hospital outcomes, including hospital mortality, length of stay, and readmission to hospital. We considered all consecutive patients who underwent gastric bypass at the University of Cincinnati Medical Center between January 2003 and January 2005. A total of 504 patients underwent gastric bypass during the study period. A historical cohort design was used by identifying all patients who underwent gastric bypass during the study period and by creating a data set with predefined characteristics, described next. Primary outcome was AKI and was defined as a ≥50% increase in serum creatinine relative to baseline during the first three postoperative days or requirement of dialysis during the postoperative period.
ATLANTA — Obese patients with chronic kidney disease who receive bariatric surgery succeed in losing weight; however, their risk for side effects and surgical complications is high, according to a new study. "Our work demonstrated the efficacy of bariatric surgery in obese patients with chronic kidney disease; however, the rate of complications is higher, and patients need to be counseled about this," said lead investigator Helen Mac Laughlin, from King's College Hospital in London. The retrospective work evaluates the medical records of 74 patients with chronic kidney disease who underwent laparoscopic bariatric surgery at 3 major London teaching hospitals. The majority of patients, 59%, had stage 3 kidney disease. Sixteen patients (22%) experienced adverse events, and there were 2 deaths related to surgical complications within 30 days of the surgery. As a result of the higher risk associated with bariatric surgery, Mac Laughlin said that her center has developed policies for the management of patients with kidney disease.
Lejuan Holmes, a kidney transplant candidate, had bariatric surgery to reduce his BMI and make him eligible for transplant surgery. Le Juan Holmes, a diabetic and a candidate for a kidney transplant, tries to get on the list after having bariatric surgery to reduce his BMI and make him eligible. Image 4 of 9. Lejuan Holmes, a kidney patient who lost his legs to diabetes-related health problems, had bariatric surgery to reduce his BMI and make him eligible for a transplant. Image 6 of 9. Image 7 of 9. Image 8 of 9. Houston Methodist is beginning to offer kidney patients the option of bariatric surgery, which helps them drop their BMI and qualify for a transplant. Transplant Center has joined forces with the bariatric surgery department, and together they're now using bariatric surgery to help some kidney patients lose weight and qualify for the transplants they need. By mid-October, Holmes was down to 275 pounds and was getting close to the BMI he needs to achieve to qualify for a kidney transplant.
Weight-Loss Surgery Seems Safe for Kidney Disease Patients. THURSDAY, March 1 (Health Day News) - Obese chronic kidney disease patients who undergo surgery to achieve weight loss do not face a particularly dangerous rate of complications as a result, a new study suggests. The findings, slated for publication in an upcoming issue of the Journal of the American Society of Nephrology, stem from an analysis of more than 27,000 patients who had bariatric surgery at some point between 2006 and 2008. Complications among kidney disease patients varied depending on the severity of their illness. The authors suggested that complication rates below 10 percent should be seen as welcome news, given the difficulty many chronic kidney disease patients have in losing weight as their ability to engage in exercise diminishes.
Home : Articles : Chronic Kidney Disease (CKD): How It Affects Bariatric Surgery. Chronic Kidney Disease (CKD): How It Affects Bariatric Surgery. New studies have emerged suggesting that bariatric surgery may help to prevent, or at least diminish, the effects of chronic kidney disease. Sufferers of chronic kidney disease that also suffer from obesity may wish to consider the benefit bariatric surgery could offer them. Chronic kidney disease is the slow, progressive loss of function in the kidneys, and may last for a period of months or years. Recent scientific studies seem to suggest bariatric surgery may not only help prevent chronic kidney disease in patients at risk, but may halt the progression of the disease altogether for those who already suffer from it. There was a directly proportional decrease in overall blood pressure for each of the patients in the study, indicating bariatric surgery was a preventative measure for CKD.
Home > Patient Blog > 5 Tips for Avoiding Kidney Stones After Weight Loss Surgery. 5 Tips for Avoiding Kidney Stones After Weight Loss Surgery. Weight Loss Surgery Can Lead to Kidney Stones. Sometimes, however, patients fail traditional weight loss methods, and go on to require weight loss, or bariatric, surgery. Calcium and oxalate are naturally absorbed by the gastrointestinal or GI tract. Following weight loss surgery, patients tend to absorb less calcium from their GI tract. Weight loss surgery patients are taught to sip fluids throughout the day. Water helps dilute oxalate in the urinary tract and prevent it from forming into crystals and stones. Following weight loss surgery, protein is emphasized as a high priority food, but that doesn’t mean that you are on a high protein diet. Therefore, exploring more plant-based protein like legumes (beans) isn’t a bad idea, and they tend to be tolerated well after weight loss surgery. Consuming water throughout the day, limiting your sodium intake, and eating a diet rich in plant-based protein are all healthy strategies that can help you manage your weight, and prevent kidney stones.
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Mac Laughlin found that 4% of the patients in the study who underwent bariatric surgery ultimately suffered from kidney injury after the surgery. Obesity is one of the common concerns in this area and can be quickly resolved with bariatric surgery, the result of which would make the patient eligible for a kidney transplant. Does this mean that bariatric surgery should be out of the question? Following gastric bypass surgery, many patients will struggle with the challenge of adjusting to their new lifestyle. Gastric Bypass Supplements.com has been serving the Bariatric Community for the past nine years. Celebrate Vitamins and Bariatric Advantage are the leaders and trusted names when it comes to bariatric nutrition supplements. Gastric Bypass Supplements.com offers a full range of Celebrate Vitamins and Supplements. It’s essential for bariatric surgery patients get the necessary nutrients and vitamins after weight-loss procedures such as gastric bypass, lap band, sleeve gastrectomy or duodenal switch. Gastric Bypass Supplements.com offers the full range of Celebrate Vitamins and Supplements so it’s easy for you to find essential nutrients required by your body. Following any weight-loss surgery such as Gastric Bypass surgery, it’s crucial that patients adhere to a strict diet for a healthy recovery, and it’s absolutely necessary to understand What to Eat After the Surgery.
The American Society of Metabolic and Bariatric Surgery state that the number of weight loss surgeries in the US increased from 13,000 in 1998 to over 200,000 in 2008. The interviews revealed that some of the women experienced a boost in self-esteem after surgery, were more outspoken, and found other people were more likely to listen to what they were saying - particularly in the workplace. Groven notes that although these factors are clearly positive outcomes, this could also be seen as a "grief" because the women realize they had to undergo weight loss surgery before seeing these outcomes. Many of the women also felt embarrassment after the surgery, particularly when it came to speaking about their weight loss. Groven found that many of the women had mixed feelings about their naked body after surgery, and many of these feelings come from the occurrence of loose skin - a common consequence of rapid weight loss. Although women can undergo surgery to remove excess skin, Groven notes that many women are not prepared to take the risks associated with this procedure, which include hematoma or seroma formation, infection and risks associated with future pregnancies. According to Groven, five of the women interviewed reported a lower quality of life after they underwent weight loss surgery, compared with their quality of life before. The five women also said they felt as if they had complete lack of energy following weight loss surgery. Some of the women who had problems with overeating before weight loss surgery continued to overeat after surgery, even though this made them ill. Although many women reported negative thoughts and health issues after weight loss surgery, none of them said they regret undergoing the procedure.
DALLAS – March 11, 2010 – Patients who undergo gastric bypass surgery experience changes in their urine composition that increase their risk of developing kidney stones, research from UT Southwestern Medical Center investigators suggests. A new study, published in the March issue of The Journal of Urology, found that some of these urinary changes place weight-loss surgery patients at higher risk for developing kidney stones than obese patients who do not undergo the procedure. One group had undergone Roux-en-Y gastric bypass (RYGB) surgery; the second group contained normal obese individuals. In addition, the amount of a chemical called citrate in the urine was low in many gastric bypass patients in comparison to the obese nonsurgical group (32 percent to 5 percent). “Almost half of the patients who had undergone gastric bypass and did not have a history of kidney stones showed high urine oxalate and low urine citrate – factors that lead to kidney-stone formation,” said Dr. Naim Maalouf , assistant professor of internal medicine in the Charles and Jane Pak Center for Mineral Metabolism and Clinical Research and the study’s lead author. The cause for stone formation after bariatric surgery is not entirely clear, but the study reinforces the message that weight-loss surgery patients and their physicians should be alert to the heightened risk, Dr. “These findings illustrate that the majority of patients are at risk for kidney-stone formation after RYGB,” Dr.
The objective of this study was to evaluate the effect of weight loss after bariatric surgery (BS) on BP, renal parameters, and renal function in 61 extremely obese (EO) patients after 24 mo of follow-up. Presurgery weight, BMI, GFR, 24-h proteinuria, and 24-h albuminuria were higher in the EO patients than in control subjects (P < 0.001). Glomerular hyperfiltration favors the occurrence of microalbuminuria and proteinuria in obese patients with unknown renal disease ( 13 ) and, in addition, can increase the progression of preexisting renal disease ( 8 , 14 , 15 ). Therefore, the aim of this study was to evaluate the effect of weight loss after BS on BP, renal parameters, and renal function in 61 extremely obese (EO) patients after 24 mo of follow-up. Of the 102 patients who underwent BS, only 61 patients (24 men and 37 women) who had biochemical and clinical studies at both 12 and 24 mo after BS were included in our study. This study was approved by the ethics committee of our hospital, and all of our patients gave their informed consent to participate in the study. All patients in the study had normal levels of serum creatinine (normal values in our laboratory 44 to 106 μmol/L), and none had a history of renal disease. The significance of differences between the control group and the obese patients was evaluated with unpaired t test or χ2 test, as appropriate. Differences within the obese group before and after BS were evaluated with paired t test or the Mc Nemar test, as appropriate. Before undergoing BS, the EO patients presented with a statistically significant elevation in BP (both SBP and DBP) compared with the control group. Although there were no differences in urea and blood creatinine between the two groups, the EO patients had a greater creatinine clearance, 24-h proteinuria, and 24-h albuminuria and a greater percentage of microhematuria than in the control group. This study demonstrates that after BS, there is a significant improvement in the renal alterations that are associated with extreme obesity (glomerular hyperfiltration, proteinuria, high albuminuria, and microhematuria), as well as in the values of SBP and DBP. This is the first study to demonstrate that EO patients present with a greater percentage of microhematuria compared with the control group and that these alterations in urinary sediment improve within 12 mo of drastic weight loss. This study shows that drastic weight loss and the subsequent decrease in glomerular filtration leads to a decrease in SBP and DBP, as shown in previous studies ( 12 , 18 , 19 , 21 ). After the drastic weight loss 24 months after BS, parameters of renal function and BP considerably improved, although a small percentage of patients still had glomerular hyperfiltration, proteinuria, and/or microalbuminuria, given that at 2 yr of follow-up the patients changed to type 1 obesity.
Surgery for Diabetes. The prevalence of diabetes is 8.9 percent for the U. Metabolic and bariatric surgery is the most effective treatment for T 2 DM among individuals who are affected by obesity and may result in remission or improvement in nearly all cases. Metabolic and Bariatric Surgery and Type 2 Diabetes. Eliminating the need for diabetes medications. Improvement or remission of diabetes with gastric bypass occurs early after surgery and before there is significant weight-loss. The remission or improvement of diabetes, however, is secondary to the weight-loss produced by the procedure, and there does not appear to be any other mechanism for diabetes improvement in band patients. Each patient’s individual risks for surgery, though, should be evaluated in the context of the duration and severity of their diabetes as well as their other obesity-related health problems. International Diabetes Foundation Position Statement on Bariatric Surgery in the Treatment of T 2 DM. The risk for complications and death with bariatric surgery is low and similar to that of well-accepted procedures such as gallbladder surgery.
If you have chronic kidney disease that progresses, you may have the option of a kidney transplant . You may have to wait for a kidney to be donated. After a kidney transplant , you will have to take medicines called immunosuppressants. You will need to take medicines for the rest of your life. Even if you take your medicines, there is a chance that your body will reject your new kidney. If this happens, you will have to resume dialysis or have another kidney transplant. The success of the transplant also depends on what kind of donor kidney you are receiving. The closer the donor kidney matches your genetic makeup , the better the chances that your body will not reject it. A kidney transplant doesn't guarantee that you will live longer than you would have without a new kidney.
Compare the benefits of bariatric surgery to the risks , and then talk to your doctor about your options. Compare the benefits of bariatric surgery to the risks, and then talk to your doctor about your options. Heart disease and high blood pressure are related health conditions. Heart disease is an umbrella term for several diseases that affect the heart and the circulatory system. You may want to compare bariatric surgery’s high resolution rates for heart disease to the long-term effects of these conditions. People living with morbid obesity are at risk for developing heart disease and high blood pressure, including conditions such as: Stomach acid splashes up into the esophagus, which can damage it and lead to painful conditions and cancer. Barrett’s esophagus which occurs because the lining of the esophagus is damaged by stomach acid and can lead to esophageal cancer. You may want to consider bariatric surgery’s resolution rates for osteoarthritis and the long-term effects of the condition. Heart disease, including hardening of the arteries, which can lead to heart attacks and stroke.
In addition to helping patients shed pounds, weight loss surgery may also improve kidney function, according to a study that will be presented at ASN Kidney Week 2014 November 11-16 at the Pennsylvania Convention Center in Philadelphia, PA. Weight loss, or bariatric, surgery is highly effective for rapid weight loss in patients with morbid obesity, who are at markedly increased risk for kidney failure . Because the effect of bariatric surgery -induced weight loss on kidney function is unknown, Alex Chang, MD (Geisinger Medical Center) and his colleagues examined the kidney health of patients who underwent bariatric surgery. The association between weight loss and increased e GFR was stronger in patients with chronic kidney disease at the start of the study than in those without. In the subset of 108 patients with albuminuria, or protein excretion in the urine (a marker of kidney dysfunction ) at the start of the study, weight loss was associated with resolution of albuminuria. "Bariatric surgery serves as a good model to examine the effects of weight loss on kidney function. Weight-loss surgery seems safe for kidney disease patients. Weight loss surgery effective in kidney disease patients, but side effects are high. Kidney disease patients who undergo weight loss surgery can successfully lose weight, but many experience significant side effects, according to a study that will be presented at ASN Kidney Week 2013 November 5-10 at the . Sleep apnea may accelerate kidney function decline in diabetic patients with kidney disease, according to a study that will be presented at ASN Kidney Week 2014 November 11-16 at the Pennsylvania Convention Center in Philadelphia, .
Diabetes and high blood pressure are closely linked to obesity, and are leading causes of kidney disease and kidney failure. Diagnosing Kidney Disease: The Symptoms. Kidney Disease Prevention and Treatment: Your Action Plan. There is a lot you can do to prevent kidney disease and/or slow its progression. Not all weight loss plans are appropriate for people with existing kidney disease. Run any diet plan by your doctor if you have kidney disease to make sure it is appropriate for your situation. "Preliminary results suggest such surgery can improve the levels of albumin in the urine for patients with chronic kidney disease [CKD]," according to the Obesity Action Coalition . When the kidneys fail, a kidney transplant is a viable and life-saving option; but only if you qualify. Too much salt increases blood pressure, which can cause kidney disease. Make sure you are screened for kidney disease if you are at risk.
Swelling due to the body keeping in fluid (may be seen in the legs, ankles, and feet) The doctor or nurse will examine you. Blood tests may help reveal the underlying cause of kidney failure. Once the cause is found, the goal of treatment is to help your kidneys work again and prevent fluid and waste from building up in your body while they heal. Usually, you will have to stay overnight in the hospital for treatment. The amount of liquid you drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the buildup of toxins that the kidneys would normally remove. Your diet may need to be high in carbohydrates and low in protein , salt, and potassium. Diuretics (water pills) may be used to help remove fluid from your body. You may need dialysis. In rare cases, the kidney damage is so great that dialysis is needed permanently. Call your health care provider if your urine output slows or stops or you have other symptoms of acute kidney failure. Treating disorders such as high blood pressure can help prevent acute kidney failure. Brenner & Rector's The Kidney.
Bariatric Surgery May Help Diabetic Kidney Disease. Bariatric surgery had better than expected results on these kidney problems, says researcher Philip R. In the study of 52 patients, over one-third had diabetic nephropathy before the surgery, says researcher Helen M. Five years after the surgery, the kidney disease resolved in 58% of these patients, Heneghan says. In addition, five years after the surgery, 44% of the patients had remission of their diabetes and one-third had improvement, she says.
Weight Loss in Adults 3 Years After Bariatric Surgery. Severely obese adults who had bariatric surgery had substantial weight loss 3 years later but varied greatly in both the amount of weight lost and in the effects on related conditions, including diabetes and high blood pressure. The most effective way for people with severe obesity to lose large amounts of weight is with bariatric surgery, operations that alter the stomach and/or intestines. Bariatric procedures promote weight loss and can improve weight-related health conditions. An NIH-funded consortium is analyzing the benefits and risks of bariatric surgery. Researchers followed more than 2,400 people, ages 18 to 78 years, who had bariatric surgery between 2006 and 2009. Three years after surgery, participants who had gastric bypass had a median weight loss of 90 pounds (31% initial weight lost). The majority of weight loss occurred within a year after surgery. However, there was great variability in the amount and pattern of weight loss. Several adverse outcomes followed the surgeries, including the need for additional bariatric procedures and a limited number of deaths. For example, a group of more than 100 women surveyed 2 years after bariatric surgery had improvements in sex hormone levels and sexual functioning. “Our study findings are the result of data collected from a multicenter patient population, and emphasize the heterogeneity in weight change and health outcomes for both types of bariatric surgery that we report. The researchers will continue to monitor the effects of bariatric surgery on the participants’ health and quality of life. Reference: Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. Perioperative Outcomes of Adolescents Undergoing Bariatric Surgery: The Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study.
Problems with the outlet of the stomach (narrowing or stretching) Be sure to discuss the procedure with your doctor. Bariatric and metabolic surgery is not cosmetic surgery. A decision to elect surgical treatment requires an assessment of the benefits and risks to the patient and the meticulous performance of the appropriate surgical procedure. The success of bariatric and metabolic surgery is dependent on long-term lifestyle changes in diet and exercise. Metabolic and bariatric and metabolic surgery is as safe or safer than other commonly performed procedures, including gall bladder surgery. 20,27 When performed at a Bariatric and Metabolic Surgery Center of Excellence, metabolic and bariatric and metabolic surgery has a mortality rate of 0.13 percent. These risks vary depending on weight, age, and medical history, and patients should discuss these with their doctor and bariatric and metabolic surgeon.
BOSTON — Bariatric surgery appears to raise the risk for acute liver failure (ALF) from acetaminophen poisoning, according to a retrospective review of adult patients. Of the 101 patients, 29% had a history of depression, 24% had a history of alcohol abuse, almost 37% had used combination drugs containing acetaminophen, 18% had had a transplant, 9% had had bariatric surgery, and 19% died. The mean time from bariatric surgery to ALF was 5.9 years (range, 2 to 9 years). There was also significantly more depression (P < .001), alcohol abuse (P < .01), and use of combination drugs containing acetaminophen (P < .001) in the acetaminophen ALF group. Conversely, the group with acetaminophen ALF had a lower proportion of transplant recipients (3.7% vs 34%; P < .001) and a lower proportion of deaths (14.8% vs 23.4%; P < .001) compared with patients with ALF from other causes. More Bariatric Surgery Patients in Acetaminophen ALF Group. Of the 54 patients with acetaminophen ALF, 9 (16.7%) had undergone bariatric surgery compared with no patients in the group with ALF from other causes (P = .003). For the groups of patients with acetaminophen ALF with or without bariatric surgery, only alcohol abuse differed between the groups, and it was more prevalent in the group without bariatric surgery: 0 of 9 in the bariatric surgery group vs 16 of 45 in the non–bariatric surgery group (35.6%) (P = .045). We found the patients with bariatric surgery did not have more depression, alcohol abuse, or the use of combination drugs, and they did not have a higher intent to cause themselves harm," Dr. The prevalence of bariatric surgery in the acetaminophen ALF group was 16.7% vs 0.66% in the general population, a 25.3-fold higher rate of bariatric surgery in the acetaminophen ALF group compared with the general population. Limitations of the study were its retrospective nature, that it was performed in a single center, and that it could not address mechanisms of increased risk for acetaminophen ALF in bariatric surgery patients.