Weight loss surgery effective in kidney disease patients, but side effects are high

Weight loss, or bariatric, surgery is currently the most effective treatment for obesity, but recent evidence suggests the complication rate may be higher in those with chronic kidney disease than in those without. To investigate, Helen MacLaughlin (King's College London) and her colleagues conducted a retrospective study of all obese patients with kidney disease who underwent laparoscopic bariatric surgery in three major London teaching hospitals from 2007 to 2012.

Information obtained from the 74 patients' medical records revealed that across all forms of surgery, excess weight was lost in 61% of patients one year post-surgery. There were 16 adverse events, including two deaths (3%) related to surgical complications. Acute kidney injury was most frequent (4%), followed by leak (3%), acidosis and elevated blood potassium levels (3%), post-operative chest infection (3%), vitamin B12/iron deficiency (3%), fistula/graft failure (3%), and heart attacks (1%). An additional four deaths occurred during the study period, including two related to cancer.

"While bariatric surgery is effective for weight loss in obese patients with chronic kidney disease, the adverse event and mortality rates are high," the authors concluded. "Identification of risk factors for adverse events and investigation of non-surgical alternatives remain priorities."