Gastric sleeve surgery in hemodialysis: A case report
| Autor: | Diana Carolina Afanador Rubio, Camilo González, Kateir Mariel Contreras Villamizar, Paola Karina García Padilla, Martha Patricia Rodríguez Sánchez |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment BMI body mass index Electric impedance Article PMS post-surgical morbidity DW dry weight 03 medical and health sciences 0302 clinical medicine Weight loss ESRD end-stage renal disease LAGB laparoscopic adjustable gastric banding medicine DDP dialysis-dependent patients Obesity Dialysis Renal dialysis Bariatric surgery Kidney business.industry RYGB Roux-en-Y gastric bypass CKD chronic kidney disease Sleep apnea NDP non-dialysis dependent patients medicine.disease LSG laparoscopic sleeve gastrectomy Surgery Transplantation medicine.anatomical_structure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Hemodialysis medicine.symptom BIA bioelectrical impedance business Bioelectrical impedance analysis Kidney disease |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Obese patients with end-stage renal disease on hemodialysis, decreases the access to kidney transplantation. • Bariatric surgery has proven to be safe and effective for weight loss. • Dialysis-dependency does not independently increase the risk for adverse outcomes after bariatric surgery. • The estimation of DW through BIA is an effective method for avoiding complications generated by excessive or deficient ultrafiltration. Introduction Morbid obesity in chronic kidney disease patients on hemodialysis limits access to renal transplantation. We report here a case of a surgical procedure for weight reduction in a hemodialysis patient and adjustment of dry weight through bioelectrical impedance. Case presentation A 44-year-old male with CKD on hemodialysis for 26 years. After 3 years on dialysis, he underwent a cadaveric kidney transplant. However, after 8 years of transplant, he loses the kidney graft and returns to dialysis treatment. The patient’s BMI increased to 42 kg/m2 and he had difficult-to-control hypertension and severe sleep apnea. Behavioral, nutritional and pharmacologic measures were not sufficient to achieve an adequate weight control. Thus, a surgical procedure for weight reduction was considered. The patient underwent a laparoscopic gastric sleeve without any complications. Dry weight was adjusted through bioelectrical impedance before each hemodialysis session. The patient did not display hypotension, cramps, or fluid overload. After a 30 kg weight loss, the patient’s BMI was 28.3 kg/m2, allowing registration on the kidney transplant waitlist. Discussion Obesity in CKD restricts access to kidney transplant waitlist. Bariatric surgery has proven to be safe and effective for sustained weight loss and it seems that the fact that a patient is dialysis dependent does not independently increase post-operatory complications. Conclusion Surgical procedures for weight reduction in dialysis patients does not independently increase the risk for adverse outcomes after bariatric surgery. The estimation of DW through BIA is an effective method for avoiding complications generated by excessive or deficient ultrafiltration. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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