title: Acute changes in renal function after laparoscopic gastric surgery for morbid obesity.
abstract: BACKGROUND
  Acute renal failure (ARF) is a serious complication that contributes to patient morbidity and may result in death. To date, no data are available regarding the predictive risk of ARF or its effect on the outcome of patients who undergo laparoscopic gastric bypass.
  
  
  METHODS
  The medical records of 1800 patients who underwent gastric bypass from July 1997 to July 2003 at a single institution were analyzed. The data collected included demographics, comorbid factors, operative details, and postoperative outcomes. Multivariant analysis was performed and the results were compared with those of 500 age-, gender-, and comorbidity-matched control patients who underwent similar operations.
  
  
  RESULTS
  The mean age was 50 +/- 8 years; 23 were men and 19 were women. Of the 1800 patients, 42 (2.3%) developed ARF after surgery. Dialysis was required in 6 patients, 2 of whom became dialysis dependent. ARF completely resolved in the remaining patients.
  
  
  CONCLUSIONS
  Primary ARF after laparoscopic gastric bypass is an uncommon complication, with an incidence of 2.3% in our institution. Patients with a body mass index >50, previous chronic renal failure, and long operating times and intraoperative hypotension are at the greatest risk of postoperative renal failure. All patients who had normal renal function preoperatively returned to normal renal function within 6 months.
authors.affiliation: Surgical Weight Control Center, Las Vegas, Nevada USA.
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Sharma
authors.forename: Jerry
authors.initials: J
authors.lastname: McCauley
authors.forename: Daniel
authors.initials: D
authors.lastname: Cottam
authors.forename: Samer G
authors.initials: SG
authors.lastname: Mattar
authors.forename: Spencer
authors.initials: S
authors.lastname: Holover
authors.forename: Ramsey
authors.initials: R
authors.lastname: Dallal
authors.forename: Jeff
authors.initials: J
authors.lastname: Lord
authors.forename: Omar
authors.initials: O
authors.lastname: Danner
authors.forename: Ramesh
authors.initials: R
authors.lastname: Ramanathan
authors.forename: George
authors.initials: G
authors.lastname: Eid
authors.forename: Philip
authors.initials: P
authors.lastname: Schauer
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D000367:Age Factors; D015992:Body Mass Index; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000601:surgery; D009846:Oliguria / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D006435:Renal Dialysis / Q000706:statistics & numerical data; D051437:Renal Insufficiency / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D003404:Creatinine