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Cited by 86Bariatric Surgery and OutcomesChronic Kidney Disease and DiabetesObesity, Physical Activity, Diet

Incidence of end-stage renal disease following bariatric surgery in the Swedish Obese Subjects Study

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Shulman, A., Peltonen, M., Sjöström, C. D., Andersson-Assarsson, J. C., Taube, M., Sjöholm, K., le Roux, C. W., Carlsson, L. M. S. +1 more·2018·International Journal of Obesity
DOI 10.1038/s41366-018-0045-xPMC PMC6019553
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Abstract

Background Obesity is a major public health problem leading to co-morbidities such as diabetes, hypertension and kidney failure. Bariatric surgery results in pronounced and maintained weight loss and prevention of obesity-related diseases and their complications. Most studies of bariatric surgery on kidney disease show improvements after surgery. However, long-term studies analyzing hard end-points are lacking. Here we report on the long-term effects of bariatric surgery compared to usual obesity care on incidence of end-stage renal disease (ESRD) alone and in combination with chronic kidney disease stage 4 (CKD4/ESRD). Methods 4047 patients were included in the Swedish Obese Subjects (SOS) study. Inclusion criteria were age 37-60 years and BMI ≥ 34 in men and BMI ≥ 38 in women. Patients in the bariatric surgery group (N = 2010) underwent banding (18%), vertical banded gastroplasty (69%), or gastric bypass (13%); controls (N = 2037) received usual obesity care. In this analysis, patients were followed up for a median time of 18 years. The incidence of ESRD and CKD4 was obtained by crosschecking the SOS database with the Swedish National Patient Register. Results During follow-up, ESRD occurred in 13 patients in the surgery group and in 26 patients in the control group (adjusted hazard ratio (HR) = 0.27; 95% CI 0.12-0.60; p = 0.001). The number of CKD4/ESRD events was 23 in the surgery group and 39 in the control group (adjusted HR = 0.33; 95% CI 0.18-0.62; p < 0.001). In both analyses, bariatric surgery had a more favorable effect in patients with baseline serum insulin levels above median compared to those with lower insulin levels (interaction p = 0.010). Treatment benefit of bariatric surgery was also greater in patients with macroalbuminuria at baseline compared to those without macroalbuminuria (interaction p < 0.001). Conclusions Our study showed for the first time that bariatric surgery is associated with a long-term protection against ESRD and CKD4/ESRD.

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Research works printed but not linked: 22

  1. [2]Flegal KM Carroll MD Ogden CL Curtin LR Prevalence and trends in obesity among US adults, 1999–2008 JAMA 2010 303 3 235 41 20071471
  2. [3]Bray GA Medical Consequences of Obesity The Journal of Clinical Endocrinology & Metabolism 2004 89 6 2583 9 15181027
  3. [4]Mokdad AH Ford ES Bowman BA Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001 JAMA 2003 289 1 76 9 12503980
  4. [5]Rhéaume C Arsenault BJ Bélanger S Pérusse L Tremblay A Bouchard C Low Cardiorespiratory Fitness Levels and Elevated Blood Pressure: What Is the Contribution of Visceral Adiposity? Hypertension 2009 54 1 91 7 19470873
  5. [6]Kazancioğlu R Risk factors for chronic kidney disease: an update Kidney International Supplements 2013 3 4 368 71 25019021 PMC4089662
  6. [7]Hunley TE Ma LJ Kon V Scope and Mechanisms of Obesity-Related Renal Disease Current opinion in nephrology and hypertension 2010 19 3 227 34 20134323 PMC2897176
  7. [8]Ejerblad E Fored CM Lindblad P Fryzek J McLaughlin JK Nyrén O Obesity and Risk for Chronic Renal Failure Journal of the American Society of Nephrology 2006 17 6 1695 702 16641153
  8. [11]Heneghan HM Cetin D Navaneethan SD Orzech N Brethauer SA Schauer PR Effects of bariatric surgery on diabetic nephropathy after 5 years of follow-up Surgery for Obesity and Related Diseases 2013 9 1 7 14 23211651
  9. [12]Miras AD Chuah LL Lascaratos G Faruq S Mohite AA Shah PR Bariatric Surgery Does Not Exacerbate and May Be Beneficial for the Microvascular Complications of Type 2 Diabetes Diabetes Care 2012 35 12 e81 23173142 PMC3507606
  10. [13]Miras AD Chuah LL Khalil N Nicotra A Vusirikala A Baqai N Type 2 diabetes mellitus and microvascular complications 1 year after Roux-en-Y gastric bypass: a case–control study Diabetologia 2015 58 7 1443 7 25893730 PMC4473013
  11. [14]Li K Zou J Ye Z Di J Han X Zhang H Effects of Bariatric Surgery on Renal Function in Obese Patients: A Systematic Review and Meta Analysis PLOS ONE 2016 11 10 e0163907 27701452 PMC5049777
  12. [15]Sjöström L Larsson B Backman L Bengtsson C Bouchard C Dahlgren S Swedish obese subjects (SOS). Recruitment for an intervention study and a selected description of the obese state Int J Obes Relat Metab Disord 1992 16 6 465 79 1322873
  13. [16]Levey AS Bosch JP Lewis JB Greene T Rogers N Roth D A More Accurate Method To Estimate Glomerular Filtration Rate from Serum Creatinine: A New Prediction Equation Annals of Internal Medicine 1999 130 6 461 70 10075613
  14. [17]Levey AS Coresh J Greene T Marsh J Stevens LA Kusek JW Expressing the Modification of Diet in Renal Disease Study Equation for Estimating Glomerular Filtration Rate with Standardized Serum Creatinine Values Clinical Chemistry 2007 53 4 766 72 17332152
  15. [18]Sugerman HJ Effects of increased intra-abdominal pressure in severe obesity Surgical Clinics of North America 2001 81 5 1063 75 11589245
  16. [19]Sjöström L Peltonen M Jacobson P Bariatric surgery and long-term cardiovascular events JAMA 2012 307 1 56 65 22215166
  17. [20]Torgerson JS Lindroos AK Naslund I Peltonen M Gallstones, gallbladder disease, and pancreatitis: Cross-Sectional and 2-year data from the Swedish obese subjects (SOS) and SOS reference studies Am J Gastroenterol 2003 98 5 1032 41 12809825
  18. [21]Sjöström L Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery Journal of Internal Medicine 2013 273 3 219 34 23163728
  19. [22]Carlsson LMS Romeo S Jacobson P Burza MA Maglio C Sjoholm K The incidence of albuminuria after bariatric surgery and usual care in swedish obese subjects (SOS): a prospective controlled intervention trial Int J Obes 2015 39 1 169 75 PMC4285618 24798033
  20. [23]Anveden Å Taube M Peltonen M Jacobson P Andersson-Assarsson JC Sjöholm K Long-term incidence of female-specific cancer after bariatric surgery or usual care in the Swedish Obese Subjects Study Gynecologic Oncology 2017 145 2 224 9 28259424 PMC5401644
  21. [24]Carlsson LMS Sjöholm K Karlsson C Jacobson P Andersson-Assarsson JC Svensson P-A Long-term incidence of microvascular disease after bariatric surgery or usual care in patients with obesity, stratified by baseline glycaemic status: a post-hoc analysis of participants from the Swedish Obese Subjects study The Lancet Diabetes & Endocrinology 2017 5 4 271 9 28237791 PMC5394228
  22. [25]Keating C Neovius M Sjöholm K Peltonen M Narbro K Eriksson JK Health-care costs over 15 years after bariatric surgery for patients with different baseline glucose status: results from the Swedish Obese Subjects study The Lancet Diabetes & Endocrinology 3 11 855 65 PMC4880549 26386667

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Authors
Shulman, A., Peltonen, M., Sjöström, C. D., Andersson-Assarsson, J. C., Taube, M., Sjöholm, K., le Roux, C. W., Carlsson, L. M. S., & Svensson, P.-A.
Affiliations
  • University of Gothenburg (SE)
  • Finnish Institute for Health and Welfare (FI)
  • AstraZeneca (Sweden) (SE)
Corresponding author
Svensson, P.-A.
ORCID
Venue
International Journal of Obesity
Publisher
Springer Science and Business Media LLC
Published
2018-02-26
Volume
42
Issue
5
Pages
964-973
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
DOI
10.1038/s41366-018-0045-x
PMC
PMC6019553
OpenAlex
W2789862618
Cited by
86
References
3
Citations by year
2026: 4 · 2025: 10 · 2024: 5 · 2023: 8 · 2022: 13 · 2021: 15 · 2020: 14 · 2019: 14 · 2018: 3
FWCI
11.71
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • International Journal of Obesity (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK105948)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
bariatric surgery, end-stage renal disease, chronic kidney disease stage 4, obesity, kidney failure prevention, insulin levels, macroalbuminuria, gastric bypass, vertical banded gastroplasty, gastric banding, Swedish Obese Subjects study, long-term outcomes
MeSH terms
Adult, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Obesity, Postoperative Complications, Sweden, Bariatric Surgery

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