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Abstract: FR-PO249

Five-Year Kidney Outcomes of Bariatric Surgery in Adolescents Compared with Adults

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Bjornstad, Petter, University of Colorado School of Medicine, Aurora, Colorado, United States
  • Jenkins, Todd, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Nehus, Edward, Cincinnati Children's Hospital, Cincinnati, Ohio, United States
  • Mitsnefes, Mark, Cincinnati Children's Hospital, Cincinnati, Ohio, United States
  • Moxey-Mims, Marva M., Children's National Health System, Washington, District of Columbia, United States
  • Inge, Thomas H., Children's Hospital Colorado, Aurora, Colorado, United States
Background

Bariatric surgery improves markers of kidney health in severely obese adults and adolescents, yet it remains unclear whether kidney disease outcomes differ according to age at surgery.

Methods

We examined health effects of Roux-en-Y gastric bypass between adolescents (n=161; enrolled 2006-2012) and adults (n=396; enrolled 2006-2009) participating in two related but distinct studies. Estimated glomerular filtration rate (eGFR) by serum creatinine and cystatin C and urine albumin-to-creatinine ratio (UACR) were compared between cohorts through 5 years after surgery. Elevated UACR (≥30mg/g) and hyperfiltration (eGFR ≥ 135 ml/min/1.73m2) were also compared. Analyses were stratified by the presence of pre-operative type 2 diabetes (pre-op T2D).

Results

The pre-op prevalence of elevated UACR was higher in adolescents than adults irrespective of pre-op T2D status. In adolescents with pre-op T2D, elevated UACR decreased from 29% prior to surgery to 6% 1 year after surgery (p=0.0041), whereas elevated UACR did not decrease significantly until year 5 after surgery in adults with pre-op T2D (p=0.0040) (Fig 1). The change in prevalence of UACR was not significantly different over time in adolescents vs. adults without pre-op T2D (p=0.95). Adolescents with pre-op T2D had an increased prevalence of hyperfiltration that remained throughout the study period (p=0.01), whereas hyperfiltration prevalence was similar in all study participants without T2D (p=0.94).

Conclusion

Adolescents with T2D experienced more hyperfiltration and earlier attenuation of elevated UACR after gastric bypass compared to adults and these differences were not observed in adolescents and adults without pre-op T2D.

Funding

  • NIDDK Support