Abstract

Purpose: Severe obesity can increase risk of complications after kidney transplantation. There is a paucity of literature on bariatric surgery outcomes in renal transplant candidates. The objective of this study was to analyze outcomes of bariatric surgery as a weight reduction strategy for patients with kidney failure to enhance eligibility for kidney transplantation. Materials and Methods: We performed a retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database at a single institution for patients with chronic kidney disease receiving hemodialysis therapy (CKD G5D) undergoing bariatric surgery between 2011 and 2018. Results: Of 2363 patients who underwent bariatric surgery, 38 (1.6%) had CKD G5D; median age (range) was 49 years (33; 69), 52.6% were female, and mean BMI was 44.2 kg/m2. Twenty-four patients underwent laparoscopic Roux-en-Y gastric bypass (LRYGB), and 14 patients underwent laparoscopic sleeve gastrectomy. Seventeen patients (46%, n=37) had a BMI≤35 at 6 months, while 25 patients (75.8%, n=33) achieved a BMI≤35 at 12 months. Of these, 18 patients (47%) were listed for kidney transplant, and 8 patients (21%) received kidney transplant. There was no statistically significant difference between sleeve and LRYGB procedures in patients who reached BMI of 35 at 12 months (P=0.58). Median length of stay was 2.3 days. Thirty-day readmission rate was 2 patients (5.3%), and 2 patients (5.3%) required reoperation (one for bleeding, one for acute recurrent hiatal hernia). No mortality occurred. Conclusion: Laparoscopic bariatric surgery offers effective weight loss for CKD G5D patients to achieve transplant eligibility with acceptable outcomes. Graphical abstract: [Figure not available: see fulltext.]

Original languageEnglish (US)
Pages (from-to)3436-3443
Number of pages8
JournalObesity Surgery
Volume31
Issue number8
DOIs
StatePublished - Aug 2021

Keywords

  • Bariatric surgery
  • Gastric bypass
  • Hemodialysis
  • Kidney transplantation
  • Laparoscopic sleeve gastrectomy
  • Bariatric Surgery
  • Gastric Bypass
  • Humans
  • Middle Aged
  • Treatment Outcome
  • Kidney Transplantation
  • Laparoscopy
  • Gastrectomy
  • Obesity, Morbid/surgery
  • Renal Insufficiency
  • Female
  • Retrospective Studies
  • Postoperative Complications
  • Renal Dialysis

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Surgery
  • Endocrinology, Diabetes and Metabolism

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