Metabolic, renal, and nutritional consequences of bariatric surgery: implications for the clinician.
Management of obesity-associated comorbidities costs about $60 billion/year, about 5% of total US healthcare expenditure. Bariatric surgery is the only proven effective weight loss therapy for severely obese patients with a BMI > or =35 kg/m2. Bariatric surgery produces long-term weight loss, improves quality of life, and reduces the number of sick days and medication costs. Surgery has a profound effect on the metabolic milieu and nutritional status from the first few days after surgery, even before significant weight loss has been achieved. Metabolic effects of bariatric surgery reduce obesity-related comorbidities like type 2 diabetes, hypertension, metabolic syndrome, and cardiovascular disease risk. Improvement in renal function is seen, but adverse effects like oxalate nephropathy can lead to chronic kidney disease or end-stage renal disease (CKD/ESRD). Surgery can also lead to micronutrient deficiencies, making dietary supplementation necessary. Reduction in insulin resistance and hypertension after surgery makes medication adjustment imperative. Improvement in comorbidities and nutritional deficiencies after bariatric surgery has important clinical implications.
Chauhan
Veeraish
V
Department of Medicine, Drexel University College of Medicine and Hahnemann University Hospital, Philadelphia, PA 19102, USA. veeraish.chauhan@drexelmed.edu
Vaid
Megha
M
Gupta
Mohit
M
Kalanuria
Atul
A
Parashar
Akhil
A
D050110:Bariatric Surgery / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000209:etiology; D009748:Nutrition Disorders / Q000188:drug therapy / Q000209:etiology; D009767:Obesity, Morbid / Q000601:surgery*