The effect of surgical weight correction on albuminuria and nephrinuria in patients with morbid obesity.

Gussaova S.S.: Sechenov First Moscow State Medical University

Bobkova I.N.: Sechenov First Moscow State Medical University

Yashkov Yu.I.: Center for Endosurgery and Lithotripsy

Stavrovskaya E.V.: Sechenov First Moscow State Medical University

Bordan N.S.: Institute of Plastic Surgery and Cosmetology

Bekuzarov D.K: Center for Endosurgery and Lithotripsy

Evdoshenko V.V.: Institute of Plastic Surgery and Cosmetology

Fedenko V.V.: Institute of Plastic Surgery and Cosmetology

Malykhina A.I.: Center for Endosurgery and Lithotripsy

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Summary

Aim

To study albuminuria and nephrinuria in patients with morbid obesity (MO) and to evaluate the impact of bariatric surgery (BS) on these parameters.

Material and methods

In 99 pts with MO who underwent BS, we measured the main anthropometric parameters, plasma glucose and cholesterol levels, glomerular filtration rate (GFR) (in all pts), urinary albumin/creatinine ratio (ACR) and nephrin urinary excretion (in 33 pts) prior and after surgery.

Results

BS resulted in a significant weight loss (on average by 50.3 kg) and reduction in plasma glucose and cholesterol levels. Within 16.7 months after BO, median GFR significantly increased (p<0.001), mainly in pts with baseline GFR<90 ml/min/1.73m2, whereas median ACR significantly decreased (p=0.005). The initial urine nephrin level in MO pts with and without albuminuria was significantly higher than in the control group. Nephrin urinary excretion directly correlated with baseline body weight (R=0.462, p<0.01), body weight excess (R=0.648, p<0.01), body mass index (R=0.755, p<0.05), waist circumference (R=0.383, p <0.05), and C-peptide level (R=0.534, p<0.05). There was a trend to nephrinuria reduction after BS in all patients and significant reduction in obese pts with diabetes mellitus. The urine nephrine decrease directly correlated with weight loss (R=0.518, p<0.01), blood cholesterol (R=0.886, p<0.05), and glucose levels reduction (R=0.890, p<0.05).

Conclusion

Nephrinuria seems to be a promising marker for early diagnosis of renal functional and structural disorders in pts with MO, for monitoring of kidney damage, and for predicting the response to treatment.

Key words

Morbid obesity, bariatric surgery, GFR, albuminuria, nephrinuria, chronic kidney disease, diabetes