Effects of Bariatric Surgery on Renal Function in Obese Patients: A Systematic Review and Meta Analysis

Autor: Qinggui Ren, Weijie Liu, Xiaodong Han, Kun Li, Hongwei Zhang, Pin Zhang, Jianzhong Di, Jianan Zou, Zhibin Ye
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
Physiology
030232 urology & nephrology
Bariatric Surgery
lcsh:Medicine
Pathology and Laboratory Medicine
urologic and male genital diseases
law.invention
0302 clinical medicine
Mathematical and Statistical Techniques
Randomized controlled trial
law
Chronic Kidney Disease
Medicine and Health Sciences
lcsh:Science
Randomized Controlled Trials as Topic
Multidisciplinary
Inulin
Middle Aged
female genital diseases and pregnancy complications
Proteinuria
Observational Studies as Topic
Treatment Outcome
Physiological Parameters
Nephrology
Meta-analysis
Physical Sciences
Female
medicine.symptom
Glomerular hyperfiltration
Statistics (Mathematics)
Research Article
Glomerular Filtration Rate
Adult
medicine.medical_specialty
Renal function
030209 endocrinology & metabolism
Surgical and Invasive Medical Procedures
Research and Analysis Methods
03 medical and health sciences
Digestive System Procedures
Young Adult
Signs and Symptoms
Diagnostic Medicine
medicine
Humans
Obesity
Statistical Methods
Renal Physiology
business.industry
urogenital system
Body Weight
lcsh:R
Biology and Life Sciences
medicine.disease
Surgery
Albuminuria
Microalbuminuria
Observational study
lcsh:Q
business
Mathematics
Kidney disease
Meta-Analysis
Zdroj: PLoS ONE, Vol 11, Iss 10, p e0163907 (2016)
PLoS ONE
ISSN: 1932-6203
Popis: Background Obesity is an independent risk factor of development and progression of chronic kidney disease (CKD). Data on the benefits of bariatric surgery in obese patients with impaired kidney function have been conflicting. Objective To explore whether there is improvement in glomerular filtration rate (GFR), proteinuria or albuminuria after bariatric surgery. Methods We comprehensively searched the databases of MEDLINE, Embase, web of science and Cochrane for randomized, controlled trials and observational studies that examined bariatric surgery in obese subjects with impaired kidney function. Outcomes included the pre- and post-bariatric surgery GFR, proteinuria and albuminuria. In obese patients with hyperfiltration, we draw conclusions from studies using measured GFR (inulin or iothalamate clearance) unadjusted for BSA only. Study quality was evaluated using the Newcastle-Ottawa Scale. Results 32 observational studies met our inclusion criteria, and 30 studies were included in the meta-analysis. No matter in dichotomous data or in dichotomous data, there were statistically significant reduction in hyperfiltration, albuminuria and proteinuria after bariatric surgery. Limitations The main limitation of this meta-analysis is the lack of randomized controlled trials (RCTs). Another limitation is the lack of long-term follow-up. Conclusions Bariatric surgery could prevent further decline in renal function by reducing proteinuria, albuminuria and improving glomerular hyperfiltration in obese patients with impaired renal function. However, whether bariatric surgery reverses CKD or delays ESRD progression is still in question, large, randomized prospective studies with a longer follow-up are needed.
Databáze: OpenAIRE