TOPLINE:

Patients with obesity who underwent metabolic and bariatric surgery (MBS) had an approximately 50% lower risk for adverse kidney outcomes than those who did not, regardless of type 2 diabetes (T2D) status.

METHODOLOGY:

• Obesity is linked to an increased risk for chronic kidney disease, but the effects of MBS on kidney outcomes in patients with obesity, with or without T2D, are not well defined.
• Researchers compared adverse kidney outcomes in patients with obesity who underwent MBS with controls who did not undergo surgery.
• Patients were stratified by T2D status into four groups: MBS with T2D (n = 1852; mean age, 48.9 years), MBS without T2D (n = 2470; mean age, 43.7 years), nonsurgical with T2D (n = 9960; mean age, 55.0 years), and nonsurgical without T2D (n = 20,959; mean age, 46.4 years).
• The primary outcome was a composite of at least one estimated glomerular filtration rate (eGFR) of 15 mL/min/1.73 m², at least one eGFR decline of ≥ 40% from baseline, or kidney failure-related death.
• The secondary kidney outcome was at least one eGFR of < 15 mL/min/1.73 m², at least two consecutive eGFR declines ≥ 40% from baseline, or kidney failure-related death; the tertiary outcome further incorporated kidney transplantation and dialysis events.

TAKEAWAY:

• Patients were followed for a mean of 6.1 years, with the mean peak reduction in body weight among patients undergoing MBS occurring at 1.5 years of follow-up.
• MBS was associated with a 53% reduced risk for the primary kidney composite outcome in patients with T2D (P < .001) and a 48% reduced risk in patients without T2D (P < .001) compared with nonsurgical controls.
• MBS was also significantly associated with 49%-58% reductions in risk for the secondary and tertiary kidney composite outcomes, regardless of T2D status, compared with controls.

IN PRACTICE:

“These results are consistent with a potential benefit of MBS as a weight loss intervention to preserve kidney function in patients with obesity, both with and without T2D,” the authors of the study wrote.

SOURCE:

The study was led by Kevin C. Maki, School of Public Health, Indiana University Bloomington, Bloomington, Indiana. It was published online in Obesity Science & Practice.

LIMITATIONS:

The study relied on retrospective observational data, which may have introduced residual confounding. Complete data were unavailable for some relevant variables, including albuminuria and medication use. All patients received care within a single health system, limiting generalizability.

DISCLOSURES:

The study was supported by funding from Eli Lilly and Company through the Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington. Some authors reported receiving research grants, consulting fees, or advisory roles with pharmaceutical companies and other organizations. Two authors are employees and stockholders of Eli Lilly and Company, and four authors are employees of the School of Public Health, Indiana University Bloomington.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.