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Abstract: FR-PO954

Longitudinal Impacts of Bariatric Surgery on Renal Function in CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Madapoosi, Siddharth S., University of Michigan, Ann Arbor, Michigan, United States
  • Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States
Background

Prior studies of obesity show improved renal function after bariatric surgery. This study examines renal function over 10 years pre- and post-bariatric surgery among patients with a reduced baseline eGFR, including patients with CKD.

Methods

Retrospective cohorts of patients with CKD and/or who underwent bariatric surgery prior to 11/30/22 were identified from the Michigan Medicine EHR using ICD-10 and CPT codes. Multivariable piecewise linear mixed models were fit on eGFR (2021 CKD-EPI), adjusting for age, gender, race, ethnicity, BMI, hypertension, diabetes, and surgery type or CKD stage. Pre- and post-surgery eGFR trajectories were compared in patients with a baseline eGFR<90. eGFR trajectories were then compared between CKD patients post-surgery and either propensity score-matched non-CKD patients post-surgery or CKD patients who did not undergo surgery.

Results

Patients with baseline eGFR<90 (n=688) had a slower annual rate of eGFR decline [95% CI] post vs. pre-surgery (-1.85 [-1.97,-1.72] vs. -3.22 [-3.41,-3.02] mL/min/1.73m2; p<0.001). Following surgery, CKD patients (n=139) had a slower annual rate of eGFR decline compared to 278 matched non-CKD patients (-1.28 [-1.87,-0.69] vs. -2.62 [-2.83,-2.41] mL/min/1.73m2; p<0.001). Annual eGFR decline was also slower among CKD patients who underwent surgery compared to 278 matched CKD patients who did not (-0.20 [-0.83,0.43] vs. -1.11 [-1.37,-0.85] mL/min/1.73m2; p<0.001).

Conclusion

Bariatric surgery is associated with a slower rate of eGFR decline in patients with a reduced baseline eGFR, including CKD patients. Future modeling of proteinuria may support these findings and identify if the faster eGFR decline in healthy patients correlates to a decrease in glomerular hyperfiltration after surgery.

Predicted values of eGFR (95% CI) from adjusted linear mixed models of (a) patients with baseline eGFR<90, (b) bariatric surgery patients with/without CKD, and (c) CKD patients with/without bariatric surgery

Funding

  • Other NIH Support