Background

In the past four years our team has presented and published our single-institution-experience demonstrating the positive effects of bariatric surgery (BaS) on Chronic Kidney disease (CKD). Therefore, the objective of this study was to assess the impact of BaS on the prevalence and likelihood of CKD and End-stage renal disease (ESRD) nation-wide.

Methods

The US National Inpatient Sample (NIS) database for the years 2010-2015 was queried for obesity, BaS, CKD and ESRD. Univariate and multivariable analysis were performed to assess the impact of BaS on the point prevalence and the probability of CKD and ESRD. Our secondary objective was to measure the impact of the most important risk factors for CKD exclusively in a severely obese-population.

Results

A total of 296,041 BaS-cases and 2,004,804 severely obese-controls were identified. After adjusting for all CKD risk factors, controls exhibited marked increases in the odds of CKD-stage III [OR 3.10(3.05-3.14) p<0.0001] and moderate increase for ESRD [OR 1.13(1.09-1.18) p<0.0001]. Overall, even after adjusting for risk factors we observed that the rate of CKD is significantly higher in the control group, 12% when compared to 5.3% in the bariatric surgery-group.

Conclusions

In this retrospective, case-control study of a large, representative national sample of severely obese-patients, BaS was found to be possibly associated with significantly reduced point-prevalence and likelihood for CKD when adjusted for baseline CKD risk factors. It also reduced the rate and presented a moderate decrease in the likelihood of ESRD.