Improvement of Renal Function After Bariatric Surgery: a Systematic Review and Meta-analysis

Obes Surg. 2021 Oct;31(10):4470-4484. doi: 10.1007/s11695-021-05630-4. Epub 2021 Aug 6.

Abstract

Background/objective: The effect of bariatric surgery in renal function varies and the postoperative benefit time point remains unclear. We aim to assess the changes of renal function after bariatric surgery (BS) in different postoperative periods and subgroups.

Methods: We searched the databases of PubMed and Cochrane from inception to December 14, 2020. Articles included in the study were drawn from all recipients of BS that provided assessments of renal function pre and post-surgery. Meta-analysis was performed to compare glomerular filtration rate (GFR), serum creatinine, albumin-to-creatinine ratio (ACR), and albuminuria before and after BS.

Results: The study included 49 articles involving 8515 patients. Compared with pre-operative renal function, the overall analysis showed that bariatric surgery significantly reduced serum creatinine levels, ACR, and albuminuria. There was significant increase of GFR in the CKD subgroup, yet a noticeable decrease in the hyperfiltration subgroup. The most significant improvement in GFR was seen 6-12 months after BS, while ACR dropped most dramatically 12-24 months after BS.

Conclusions: Bariatric surgery can improve renal function in obese patients with kidney dysfunction, especially 1 year after surgery.

Keywords: Bariatric surgery; Meta-analysis; Obesity; Renal function.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Bariatric Surgery*
  • Glomerular Filtration Rate
  • Humans
  • Kidney / physiology
  • Obesity, Morbid* / surgery
  • Renal Insufficiency, Chronic*