Surgery dramatically reduces risk of kidney failure

Metabolic and bariatric surgery dramatically improves outcomes for patients with obesity and chronic kidney disease (CKD), significantly reducing the risk of kidney failure, major cardiovascular events (MACE) and death, according to research, ‘Long-term renal and survival outcomes in patients with obesity and chronic kidney disease following metabolic and bariatric surgery: A Trinetx cohort study (Abstract ID: 4520)’ presented at the annual meeting of the American Society for Metabolic and Bariatric Surgery.

Jerry Dang

“These findings show metabolic and bariatric surgery doesn’t just treat obesity, it fundamentally alters the course of chronic kidney disease and should be considered earlier in the disease process,” said lead study author, Dr Jerry Dang, Associate Professor of Surgery at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. “With earlier intervention, we see slower disease progression, fewer patients advancing to kidney failure, better cardiovascular outcomes and greater access to life-saving transplants.”

In the real-world analysis of more than 8,900 patients with obesity and CKD, researchers compared the five-year outcomes of patients who had either sleeve gastrectomy or Roux-en-Y gastric bypass to patients of similar health status who did not have surgery. Data from 2010 to 2020 was obtained from the TriNetX Research Network electronic health record database.

CKD Patients who had metabolic and bariatric surgery cut their risk in half for developing end stage kidney disease (5.9% vs. 11.9%), were about 60% less likely to need dialysis (4.1% vs. 9%) and more than twice as likely to receive a kidney transplant, 4.6% vs. 2.2%. Heart attack and stroke risk also dropped by nearly half (15.5% vs. 27.7%), and the mortality rate plummeted by over 75% (5% vs. 16%).

“The survival benefit of surgery patients observed in this study is extraordinary but not surprising,” said Richard M Peterson, President, ASMBS, who was not involved in the study. “These procedures are not simply about weight loss, they’re about changing the trajectory of chronic disease, preserving organ function and saving lives.”