title: Renal Function and Remission of Hypertension After Bariatric Surgery: a 5-Year Prospective Cohort Study.
abstract: This study examines the effect of Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB) on renal function for at least 5 years post-operatively in a tertiary referral center for bariatric surgery.
  
  
  
  This prospective cohort study of patients undergoing RYGB and LAGB measured renal function, blood pressure, and diabetes status pre-operatively and then 1 and 5 years post-operatively. Renal function was assessed using the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Cockcroft-Gault formulae. Hypertension and diabetes were defined by the European Society of Hypertension and European Society of Cardiology joint guidelines and American Diabetes Association guidelines, respectively. A sub-group who had completed 10 years post-operative follow-up was also included.
  
  
  
  Estimated glomerular filtration rate (eGFR) increased over 5 years after RYGB (N = 190; 94 ± 2 mL/min/1.73 m2to 102 ± 22 mL/min/1.73 m2, p = 0.01) and LAGB (N = 271; 88 ± 1 to 93 ± 22 mL/min/1.73 m2, p = 0.02). In a sub-group with up to 10 years post-operative date, this trend was maintained. In patients with renal impairment, eGFR improved over 5 years (52 ± 2 to 68 ± 7 mL/min/1.73 m2, p = 0.01). Remission of hypertension was greater after RYGB than LAGB at 1 year (32 vs. 16 %, p = 0.008) and at 5 years post-operatively (23 vs. 11 %, p = 0.02).
  
  
  
  Bariatric surgery stabilizes eGFR post-operatively for at least 5 years. In a sub-group with renal impairment, eGFR is increased in the first post-operative year and this is maintained for up to 5 years. RYGB is an effective procedure in achieving blood pressure control.
authors.affiliation: Diabetic Complication Research Centre, UCD Conway Institute, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Neff
authors.affiliation: General and Endocrine Surgery, Lille University Hospital, Lille, France.|Inserm U 1190, European Genomic Institute for Diabetes, Lille University, Lille, France.
authors.forename: Gregory
authors.initials: G
authors.lastname: Baud
authors.affiliation: General and Endocrine Surgery, Lille University Hospital, Lille, France.|Inserm U 1190, European Genomic Institute for Diabetes, Lille University, Lille, France.
authors.forename: Violeta
authors.initials: V
authors.lastname: Raverdy
authors.affiliation: General and Endocrine Surgery, Lille University Hospital, Lille, France.|Inserm U 1190, European Genomic Institute for Diabetes, Lille University, Lille, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Caiazzo
authors.affiliation: General and Endocrine Surgery, Lille University Hospital, Lille, France.|Inserm U 1190, European Genomic Institute for Diabetes, Lille University, Lille, France.
authors.forename: Helene
authors.initials: H
authors.lastname: Verkindt
authors.affiliation: Nephrology, Lille University Hospital, Lille, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Noel
authors.affiliation: Diabetic Complication Research Centre, UCD Conway Institute, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.|Gastrosurgical Laboratory, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Carel W
authors.initials: CW
authors.lastname: le Roux
authors.affiliation: General and Endocrine Surgery, Lille University Hospital, Lille, France. fpattou@univ-lille2.fr.|Inserm U 1190, European Genomic Institute for Diabetes, Lille University, Lille, France. fpattou@univ-lille2.fr.
authors.forename: François
authors.initials: F
authors.lastname: Pattou
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000502:physiology*; D007677:Kidney Function Tests / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D012074:Remission Induction; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology / Q000601:surgery; D015431:Weight Loss / Q000502:physiology
keywords: Banding; Bariatric surgery; Hypertension; Kidney disease; RYGB; Renal function