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Measurement of glomerular filtration rate in patients undergoing obesity surgery

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Title: Measurement of glomerular filtration rate in patients undergoing obesity surgery
Authors: Chuah, LL
Miras, AD
Perry, LM
Frankel, AH
Towey, DJ
Al-Mayahi, Z
Svensson, W
Le Roux, CW
Item Type: Journal Article
Abstract: Background Most studies on obesity surgery have measured renal function using the estimated GFR. However, due to the reduction of muscle mass, and therefore creatinine that accompanies weight loss, such measures can falsely suggest an improvement in renal function. To balance the risks of surgery versus any potential benefits on renal function, we need to be able to determine renal function using valid and reliable methodologies. In this pilot study we aimed to measure renal function in patients with CKD undergoing obesity surgery using the gold standard 51Cr-EDTA GFR clearance methodology which is independent of measures of muscle mass. Methods Nine consecutive obese patients with CKD underwent obesity surgery. Their renal function was assessed using 51Cr-EDTA GFR, cystatin C and serum creatinine as well as using eGFR equations including MDRD CKD Epi, Cockcroft Gault and CKD Epi cystatin before and 12 months after surgery. Results Renal function using the 51Cr-EDTA measured GFR did not change significantly after surgery. Similar results were obtained when Cystatin C, CKD Epi cystatin, CKD Epi cystatin creatinine and adjusted Cockcroft Gault Creatinine clearance methods were used. In contrast there were either trends or significant improvements in renal function measured using the MDRD and CKD Epi equations. Conclusions In this pilot study using the gold standard 51Cr-EDTA method we found stabilisation in renal function after obesity surgery. Until further definitive data emerge it is critical to balance the risk and benefits of surgery, especially if renal function may not improve as often as previously suggested.
Issue Date: 29-Dec-2018
Date of Acceptance: 17-Dec-2018
URI: http://hdl.handle.net/10044/1/66822
DOI: https://dx.doi.org/10.1186/s12882-018-1188-7
ISSN: 1471-2369
Publisher: BioMed Central
Journal / Book Title: BMC Nephrology
Volume: 19
Copyright Statement: © The Author(s). 2018Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Sponsor/Funder: Medical Research Council (MRC)
ONO Pharmaceuticals Co Ltd
Funder's Grant Number: G0902002
Keywords: Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
1103 Clinical Sciences
Publication Status: Published
Article Number: ARTN 383
Appears in Collections:Department of Medicine (up to 2019)