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Incidence of end-st...
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Shulman, Alexander,1978Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
(författare)
Incidence of end-stage renal disease following bariatric surgery in the Swedish Obese Subjects Study.
- Artikel/kapitelEngelska2018
Förlag, utgivningsår, omfång ...
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2018-02-26
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Springer Science and Business Media LLC,2018
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LIBRIS-ID:oai:gup.ub.gu.se/266061
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https://gup.ub.gu.se/publication/266061URI
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https://doi.org/10.1038/s41366-018-0045-xDOI
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Obesity is a major public health problem leading to co-morbidities such as diabetes, hypertension and kidney failure. Bariatric surgery results in pronounced and maintained weight loss and prevention of obesity-related diseases and their complications. Most studies of bariatric surgery on kidney disease show improvements after surgery. However, long-term studies analyzing hard end-points are lacking. Here we report on the long-term effects of bariatric surgery compared to usual obesity care on incidence of end-stage renal disease (ESRD) alone and in combination with chronic kidney disease stage 4 (CKD4/ESRD).4047 patients were included in the Swedish Obese Subjects (SOS) study. Inclusion criteria were age 37-60 years and BMI≥34 in men and BMI≥38 in women. Patients in the bariatric surgery group (N=2010) underwent banding (18%), vertical banded gastroplasty (69%), or gastric bypass (13%); controls (N=2037) received usual obesity care. In this analysis, patients were followed up for a median time of 18 years. The incidence of ESRD and CKD4 was obtained by crosschecking the SOS database with the Swedish National Patient Register.During follow-up, ESRD occurred in 13 patients in the surgery group and in 26 patients in the control group (adjusted hazard ratio (HR)=0.27; 95% CI 0.12-0.60; p=0.001). The number of CKD4/ESRD events was 23 in the surgery group and 39 in the control group (adjusted HR=0.33; 95% CI 0.18-0.62; p<0.001). In both analyses, bariatric surgery had a more favorable effect in patients with baseline serum insulin levels above median compared to those with lower insulin levels (interaction p=0.010). Treatment benefit of bariatric surgery was also greater in patients with macroalbuminuria at baseline compared to those without macroalbuminuria (interaction p<0.001).Our study showed for the first time that bariatric surgery is associated with a long-term protection against ESRD and CKD4/ESRD.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Peltonen, Markku,1967
(författare)
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Sjöström, C D
(författare)
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Andersson-Assarsson, Johanna C.,1974Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xanjoh
(författare)
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Taube, MagdalenaGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xtaubm
(författare)
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Sjöholm, Kajsa,1971Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xsjohk
(författare)
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le Roux, Carel W
(författare)
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Carlsson, Lena M S,1957Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xcarle
(författare)
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Svensson, Per-Arne,1969Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Health and Care Sciences,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xsvper
(författare)
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Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:International journal of obesity: Springer Science and Business Media LLC42, s. 964-9731476-54970307-0565
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