Impact of Preoperative Anemia on Postoperative Kidney Function Following Laparoscopic Bariatric Surgery

Obes Surg. 2019 Aug;29(8):2527-2534. doi: 10.1007/s11695-019-03869-6.

Abstract

Background: Preoperative anemia is a risk factor for acute kidney failure after high-risk surgeries. We assessed the impact of preoperative anemia on kidney function in an obese Asian population after laparoscopic bariatric surgery.

Methods: Patient characteristics, comorbidities, type of surgery, perioperative profiles, eGFR, and micronutrition were retrospectively reviewed in 341 patients with obesity undergoing bariatric surgery. All patients, who had a preoperative estimated glomerular filtration rates (eGFR) ≥ 90 mL/min/1.73 m2, were followed for 1 year and assigned to one of two groups: anemia or non-anemia group. Preoperative anemia was determined based on hemoglobin concentration.

Results: The Pearson's correlation coefficient between preoperative body mass index (BMI) and preoperative eGFR of all patients was 0.169 (p = 0.005). Preoperatively, there were no significant differences in age, BMI, and eGFR between the anemia (n = 38) and non-anemia groups (n = 303). Patients in the anemia group had lower hemoglobin concentration at baseline, 1 month, and 12 months after surgery than those in the non-anemia group. Postoperative eGFR levels at 1 month (p = 0.993) and 1 year (p = 0.118) as well as hospital stay (p = 0.941) were comparable between the two groups. However, the percentage weight loss was significantly higher in the non-anemia group than that in the anemia group 1 year after bariatric surgery (30.0 ± 7.3% vs. 27.0 ± 8.1%; p = 0.041).

Conclusions: Preoperative anemia did not negatively impact kidney function following laparoscopic bariatric surgery during the 12-month follow-up. Considering the potential adverse impact of anemia on postoperative weight loss, preoperative correction of anemia may be recommended.

Keywords: Bariatric surgery; Glomerular filtration rate; Renal function.

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology
  • Adult
  • Anemia / complications*
  • Anemia / diagnosis
  • Anemia / physiopathology
  • Anemia / surgery*
  • Bariatric Surgery* / rehabilitation
  • Body Mass Index
  • Female
  • Glomerular Filtration Rate / physiology
  • Humans
  • Kidney / physiopathology*
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Obesity, Morbid / complications*
  • Obesity, Morbid / diagnosis
  • Obesity, Morbid / physiopathology
  • Obesity, Morbid / surgery*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Period
  • Preoperative Period
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Weight Loss