Abstract
Purpose: Severe obesity can increase risk of complications after kidney transplantation. There is a paucity of literature on bariatric surgery outcomes in renal transplant candidates. The objective of this study was to analyze outcomes of bariatric surgery as a weight reduction strategy for patients with kidney failure to enhance eligibility for kidney transplantation. Materials and Methods: We performed a retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database at a single institution for patients with chronic kidney disease receiving hemodialysis therapy (CKD G5D) undergoing bariatric surgery between 2011 and 2018. Results: Of 2363 patients who underwent bariatric surgery, 38 (1.6%) had CKD G5D; median age (range) was 49 years (33; 69), 52.6% were female, and mean BMI was 44.2 kg/m2. Twenty-four patients underwent laparoscopic Roux-en-Y gastric bypass (LRYGB), and 14 patients underwent laparoscopic sleeve gastrectomy. Seventeen patients (46%, n=37) had a BMI≤35 at 6 months, while 25 patients (75.8%, n=33) achieved a BMI≤35 at 12 months. Of these, 18 patients (47%) were listed for kidney transplant, and 8 patients (21%) received kidney transplant. There was no statistically significant difference between sleeve and LRYGB procedures in patients who reached BMI of 35 at 12 months (P=0.58). Median length of stay was 2.3 days. Thirty-day readmission rate was 2 patients (5.3%), and 2 patients (5.3%) required reoperation (one for bleeding, one for acute recurrent hiatal hernia). No mortality occurred. Conclusion: Laparoscopic bariatric surgery offers effective weight loss for CKD G5D patients to achieve transplant eligibility with acceptable outcomes. Graphical abstract: [Figure not available: see fulltext.]
Original language | English (US) |
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Pages (from-to) | 3436-3443 |
Number of pages | 8 |
Journal | Obesity Surgery |
Volume | 31 |
Issue number | 8 |
DOIs | |
State | Published - Aug 2021 |
Keywords
- Bariatric surgery
- Gastric bypass
- Hemodialysis
- Kidney transplantation
- Laparoscopic sleeve gastrectomy
- Bariatric Surgery
- Gastric Bypass
- Humans
- Middle Aged
- Treatment Outcome
- Kidney Transplantation
- Laparoscopy
- Gastrectomy
- Obesity, Morbid/surgery
- Renal Insufficiency
- Female
- Retrospective Studies
- Postoperative Complications
- Renal Dialysis
ASJC Scopus subject areas
- Nutrition and Dietetics
- Surgery
- Endocrinology, Diabetes and Metabolism