Bariatric surgery for obesity-associated decline in kidney function: filling the knowledge gap?
Chang et al. (2016) report a significantly lower risk of decline in estimated glomerular filtration rate among obese adults who underwent bariatric surgery compared with a matched nonsurgical cohort. In this propensity-matched analysis, data on confounding variables such as albuminuria, psychosocial, and medical conditions that precluded surgery in the comparator arm and health insurance are lacking. Furthermore, creatinine-based estimated glomerular filtration rate is not an accurate measure of kidney function after intentional weight loss. Although the study is interesting, physicians need to carefully weigh the risks versus benefits of bariatric surgery among obese adults at risk of kidney disease.
Division of Nephrology and Hypertension, University of Vermont, Burlington, Vermont, USA. Electronic address: varunagrawal1996@yahoo.com.
Varun
V
Agrawal
Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; Section of Nephrology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
Sankar D
SD
Navaneethan
D000419:Albuminuria; D050110:Bariatric Surgery; D005919:Glomerular Filtration Rate; D006801:Humans; D009765:Obesity / Q000601:surgery*; D015431:Weight Loss