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Backgound <p>The effects of bariatric surgery on kidney function remain controversial. This study aims to assess changes in kidney function, with a specific focus on structural biomarkers, in individuals with obesity but without evident kidney disease following bariatric surgery.</p> Methods <p>Fifty-two patients with obesity and an estimated glomerular filtration rate from creatinine and cystatin C (eGFRcr-cyc) of at least 90&#xa0;mL/min/1.73 m<sup>2</sup> underwent sleeve gastrectomy (SG). Serum levels of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were measured at baseline, one month, and one year postoperatively to assess structural injury.</p> Results <p>eGFRcr-cyc decreased one month postoperatively (117.4 [103.2,133.2] to 105.8 [97.0,122.7] mL/min/1.73 m<sup>2</sup>), but restored to near baseline levels by one year (112.2 [107.2,122.4] mL/min/1.73 m<sup>2</sup>). KIM-1 levels showed no significant change at one month (53.4 [35.6,73.9] to 38.2 [21.6,68.5] pg/mL), while NGAL levels increased (56.2 [47.0,67.0] to 70.9 [52.6,88.0] ng/mL). At one year, both KIM-1 (56.7 [32.0,105.3] pg/mL) and NGAL (77.4 [57.4,96.0] ng/mL) levels remained elevated compared to baseline. Ten individuals who achieved normal weight postoperatively had lower KIM-1 (29.8 [27.1,43.4] vs. 73.3 [39.5,113.6] pg/mL) and NGAL (61.5 [52.3,71.1] vs. 84.0 [59.9,97.3] ng/mL) levels at one year compared to those who remained overweight or obese.</p> Conclusion <p>Although the kidney functional biomarker, eGFRcr-cyc, did not change, structural injury biomarkers, including KIM-1 and NGAL, increased one year post-SG. These findings underscore the importance of weight management and highlight the necessity for continued, long-term monitoring of kidney function in this patient population to mitigate potential subclinical kidney injury.</p>

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Subclinical renal injury in obesity following bariatric surgery: insights from a prospective cohort

  • 期刊论文

  • 发表日期：

    2025年12月10日

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  • Po-Jen Yang,
  • Wei-Shiung Yang,
  • Po-Chu Lee,
  • Chiung-Nien Chen,
  • Ming-Tsan Lin,
  • Vin‐Cent Wu

摘要

Backgound

The effects of bariatric surgery on kidney function remain controversial. This study aims to assess changes in kidney function, with a specific focus on structural biomarkers, in individuals with obesity but without evident kidney disease following bariatric surgery.

Methods

Fifty-two patients with obesity and an estimated glomerular filtration rate from creatinine and cystatin C (eGFRcr-cyc) of at least 90 mL/min/1.73 m2 underwent sleeve gastrectomy (SG). Serum levels of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were measured at baseline, one month, and one year postoperatively to assess structural injury.

Results

eGFRcr-cyc decreased one month postoperatively (117.4 [103.2,133.2] to 105.8 [97.0,122.7] mL/min/1.73 m2), but restored to near baseline levels by one year (112.2 [107.2,122.4] mL/min/1.73 m2). KIM-1 levels showed no significant change at one month (53.4 [35.6,73.9] to 38.2 [21.6,68.5] pg/mL), while NGAL levels increased (56.2 [47.0,67.0] to 70.9 [52.6,88.0] ng/mL). At one year, both KIM-1 (56.7 [32.0,105.3] pg/mL) and NGAL (77.4 [57.4,96.0] ng/mL) levels remained elevated compared to baseline. Ten individuals who achieved normal weight postoperatively had lower KIM-1 (29.8 [27.1,43.4] vs. 73.3 [39.5,113.6] pg/mL) and NGAL (61.5 [52.3,71.1] vs. 84.0 [59.9,97.3] ng/mL) levels at one year compared to those who remained overweight or obese.

Conclusion

Although the kidney functional biomarker, eGFRcr-cyc, did not change, structural injury biomarkers, including KIM-1 and NGAL, increased one year post-SG. These findings underscore the importance of weight management and highlight the necessity for continued, long-term monitoring of kidney function in this patient population to mitigate potential subclinical kidney injury.