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Comparative Effectiveness of Roux-En-Y Gastric Bypass Vs. One Anastomosis Gastric Bypass on Kidney Function Publisher Pubmed



Mahmoudieh M1 ; Keleidari B1 ; Hadipour P1 ; Sheikhbahaei E2 ; Chang AR3 ; Ramtin S2 ; Shahabi S1
Authors
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Authors Affiliations
  1. 1. Department of Surgery, Isfahan Minimally Invasive Surgery and Obesity Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Kidney Health Research Institute, Geisinger Health, Danville, Philadelphia, PA, United States

Source: Obesity Surgery Published:2021


Abstract

Purpose: Obesity and its associated medical problems increase risk of kidney function decline while prior studies suggest that bariatric surgery may improve kidney outcomes. However, little is known about the comparative effectiveness of different types of bariatric surgery on kidney function. In this study, we compare the effects of laparoscopic one anastomosis gastric bypass (LOAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) on kidney function one year after surgery. Materials and Methods: The patients’ demographic, medical, and surgical data were prospectively collected and retrospectively reviewed. Type 2 diabetes mellitus, hypertension, and dyslipidemia, body mass index (BMI), and kidney function tests were obtained before and one year after surgery. Kidney function was evaluated by estimated glomerular filtration rate (eGFR) and spot urine albumin to creatinine ratio (ACR). Changes in eGFR and ACR were compared between LRYGB vs. LOAGB after adjustment for confounders (age, sex, remission of associated medical problems, preoperative BMI, and percentage of excess BMI loss) using ANCOVA model. Results: Both surgical techniques significantly decreased the post-surgery presence of diabetes, hypertension, and dyslipidemia (p < 0.001 for all paired comparisons). The eGFR level significantly increased and the ACR level significantly decreased in both groups (p < 0.001 for all paired comparisons before and after adjustment). However, eGFR and ACR mean differences between LRYGB and LOAGB were not significantly different after adjustment for confounding variables (p = 0.9 and 0.4, respectively). Conclusion: Both LOAGB and LRYGB improved 1-year eGFR and ACR equally independently from weight loss and other confounders. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
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