title: Subclinical kidney injury before and 1 year after bariatric surgery among adolescents with severe obesity.
abstract: OBJECTIVE
  To assess subclinical kidney injury in adolescents with severe obesity by measuring biomarkers of early kidney disease and to assess changes in the levels of these biomarkers following bariatric procedures.
  
  
  METHODS
  Twenty-two adolescents undergoing bariatric surgery with no microalbuminuria and normal kidney function were selected. Urinary NGAL, IL-18, and KIM-1 were measured at baseline, 6 and 12 months postoperatively. Biomarker levels were compared to 44 age-gender-matched lean controls.
  
  
  RESULTS
  Subjects with obesity had a mean baseline BMI of 48 kg/m(2) that decreased by 34% at 1-year follow-up. Urine NGAL, IL-18, and KIM-1 were significantly elevated in subjects with obesity compared to lean controls at baseline. The obese cohort had a further significant increase in NGAL and KIM-1 at 6 months, followed by decline at 1 year. The overall change in levels of all three biomarkers through 1 year after surgery, however, was not significant compared to baseline.
  
  
  CONCLUSIONS
  Adolescent severe obesity is associated with increased urinary excretion of novel biomarkers of kidney injury, despite no microalbuminuria or decreased kidney function. This subclinical kidney injury persists 1 year after significant weight loss induced by bariatric surgery, suggesting that close, long-term follow-up of kidney status is warranted in these adolescents.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Nianzhou
authors.initials: N
authors.lastname: Xiao
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Prasad
authors.initials: P
authors.lastname: Devarajan
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Jenkins
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Bennett
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Mitsnefes
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000601:surgery; D000209:Acute-Phase Proteins / Q000652:urine*; D000293:Adolescent; D050110:Bariatric Surgery / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D020382:Interleukin-18 / Q000652:urine*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine*; D009767:Obesity, Morbid / Q000378:metabolism* / Q000601:surgery; D063766:Pediatric Obesity / Q000378:metabolism* / Q000601:surgery; D011518:Proto-Oncogene Proteins / Q000652:urine*; D011991:Receptors, Virus; D018709:Statistics, Nonparametric
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus