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Impact of rapid weight loss after bariatric surgery on the prevalence of arterial hypertension in severely obese patients with chronic kidney disease

  • 2019 SAGES Oral
  • Published:
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Abstract

Background

Arterial hypertension (HTN) is one of the most important risk factors for the development and progression of chronic kidney disease (CKD). Rapid weight loss after bariatric interventions has a positive impact on blood pressure levels of hypertensive patients. The aim of our study is to assess the prevalence of HTN in patients with CKD after bariatric surgery (BS).

Methods

We retrospectively reviewed severely obese patients who underwent BS from 2010 to 2017. We used guidelines of the American College of Cardiology to define HTN. Only patients meeting ACC criteria and the calculation of estimated glomerular filtration rate (eGFR) using CKD epidemiology collaboration study equation preoperatively and at 12-month follow-up were included in the analysis.

Results

From a total of 2900 patients, 29.13% (845) met the required criteria and had variables for the calculation of eGFR recorded preoperatively. 36.92% (312) had preoperative HTN and s classified as CKD stage ≥ 2. We observed a predominantly female population 63.83% (203) with mean age of 54.10 ± 11.58. Patients preoperatively classified in CKD 2, 3a, and 3b exhibited the greatest prevalence reduction of HTN at 12-month follow-up (68.59%, n = 214 vs. 36.59%, n = 114; 16.67%, n = 52 vs. 6.41%, n = 20; 7.69%, n = 24 vs. 1.28%, n = 4; p < 0.0001). A marked improvement in CKD was also observed along with improvement in HTN. The greatest benefit corresponded to patients classified preoperatively in CKD 2, 3a and 3b. A total of n = 70 (62.5%) patients with HTN were classified as CKD 2 preoperatively compared to n = 55 (49.11%) at 12-month follow-up (p = 0.0436). Similarly, n = 22 (19.64%) patients with HTN were classified preoperatively as CKD 3a compared to n = 7 (6.25%) and n = 12 (10.71%) patients as CKD 3b compared to n = 4 (3.57%) during the same time period (p = 0.0028, p = 0.0379, respectively).

Conclusions

Rapid weight loss after BS significantly reduces prevalence of HTN in all stages of CKD at 12-month follow-up. Additionally, there was a positive impact on classification of CKD at 12-month follow-up.

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Authors and Affiliations

  1. Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA

    Camila Ortiz-Gomez, David Romero-Funes, David Gutierrez-Blanco, Joel S. Frieder, Maria Fonseca-Mora, Emanuele Lo Menzo, Samuel Szomstein & Raul J. Rosenthal

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  1. Camila Ortiz-Gomez
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  2. David Romero-Funes
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  3. David Gutierrez-Blanco
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  5. Maria Fonseca-Mora
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  6. Emanuele Lo Menzo
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  8. Raul J. Rosenthal
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Correspondence to Raul J. Rosenthal.

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Camila Ortiz‑Gomez, David Romero‑Funes, David Gutierrez‑Blanco, Joel S. Frieder, Maria Fonseca‑Mora, Emanuele Lo Menzo, Samuel Szomstein, and Raul J. Rosenthal have no conflicts of interest or financial ties to disclose.

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Ortiz-Gomez, C., Romero-Funes, D., Gutierrez-Blanco, D. et al. Impact of rapid weight loss after bariatric surgery on the prevalence of arterial hypertension in severely obese patients with chronic kidney disease. Surg Endosc 34, 3197–3203 (2020). https://doi.org/10.1007/s00464-019-07094-1

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