Kidney Week

Abstract: SA-PO170

Bariatric Surgery Reduces Proteinuria in Severely Obese Patients with Normal Kidney Function by Reducing Systemic Inflammation

Session Information

• Nutrition, Inflammation, Metabolism: Clinical Trials, Biomarkers, Epidemiology
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Nutrition, Inflammation, and Metabolism

• 1401 Nutrition, Inflammation, Metabolism

Authors

• Cho, Nam-Jun, Soon Chun Hyang University College of Medicine, Cheonan Hospital, Cheonan, Korea (the Republic of)

Nam-Jun Cho,

• Gil, Hyo-Wook, Soon Chun Hyang University College of Medicine, Cheonan Hospital, Cheonan, Korea (the Republic of)

Hyo-Wook Gil,

• Choi, Chi-Young, Soon Chun Hyang University College of Medicine, Cheonan Hospital, Cheonan, Korea (the Republic of)

Chi-Young Choi,

Background

Obesity are associated with renal disease, including proteinuria, chronic kidney disease (CKD) and progression to end-stage renal disease. Bariatric surgery (BS) reduce proteinuria and improve renal function. The mechanism include improved blood pressure, improved glucose homeostasis, and reduced systemic inflammation associated with weight loss. However, it is unclear whether the mechanism by which BS reduces albuminuria is due to weight loss per se or by improved systemic inflammation induced by weight loss. To elucidate whether weight loss directly reduces albuminuria or via improvement of systemic inflammation induced by weight loss, a prospective cohort study was performed.

Methods

Patients older than 18 years who received BS in Soonchunhyang University Hospital from 1 January 2011 to 31 December 2011 were included. Other including criteria were followed: body mass index (BMI) ≥ 30, serum creatinine level ≤ 1.0, and without over proteinuria (dip stick ≤ trace). The patients were followed at 1, 6 months after BS.

Results

Forty-three patients were included. Three patients were men, 10 patients had diabetes, 12 patients had hypertension. eGFR estimated by CKD-EPI equation were 115.7 ± 16.5. There were significant reduction in body weight (98.9 ± 17.6 to 78.1 ± 14.8 kg), BMI (36.9 [34.0 – 42.8] to 29.5 [26.6 – 32.2] kg/m²), high-sensitivity C-reactive protein (hs-CRP, 0.39 [0.24 – 0.69] to 0.09 [0.05 – 0.23] mg/L), and urine albumin-to-creatinine ratio (17.95 [6.81 – 72.89] to 8.11 [4.67 – 15.92] mg/g). There were positive correlations between delta hs-CRP and delta body weight (r = 0.349, p = 0.043) or delta BMI (r = 0.362, p 0.035); between hs-CRP and body weight (r = 0.374, p = 0.001) or BMI (r = 0.431, p < 0.001). In a multivariate analysis using linear mixed model demonstrated that hs-CRP (β = 0.5451, p = 0.022) is independent risk factors to affect ACR.

Conclusion

Our results suggests that weight loss by BS directly improve systemic inflammation, which subsequently leads to reduce albuminuria.