#3182 Chronic kidney disease (CKD) in patients with obesity who underwent bariatric surgery

Abstract Background and Aims Obesity is associated with an increased risk of chronic kidney disease (CKD), CKD progression, and end-stage renal disease. Focal segmental glomerulosclerosis and obesity-related glomerulopathy, both of which are linked to proteinuria, have been described in patients with severe obesity. Obesity-related glomerulopathy may be reversible with weight loss and data suggest that bariatric surgery leads to significant improvements in markers of obesity-related nephropathy and CKD. The aim of this study was to evaluate the prevalence of CKD in patients with obesity who underwent bariatric surgery, as well as the evolution of kidney function post-surgery. Method We included patients with obesity who underwent bariatric surgery between 2022 and 2024 at Germans Trias i Pujol Hospital. Data on creatinine levels and urinary albumin-to-creatinine ratio (UACR) were assessed prior to surgery and at the end of 2024. Results Between 2022 and 2024, 253 bariatric surgeries were performed. Of these, 76% (n = 192) of the patients were women, and the average age was 50 ± 10 years. Prior to bariatric surgery, 15% (n = 37) of patients had a diagnosis of CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² and/or a UACR >30 mg/g. Among these, 78% (n = 29) had albuminuria, and after bariatric surgery, 66% (n = 19) experienced remission of albuminuria. In 29% (n = 8), albuminuria did not remit but the ratio decreased. During follow-up, 14% (n = 5) of CKD patients required renal replacement therapy; four patients underwent hemodialysis (those with the worst prognosis and greatest complications), and one patient received a kidney transplant. After bariatric surgery (by the end of 2024), only 20 patients remained diagnosed with CKD, indicating a remission of the disease in 46% of the CKD cases. Conclusion In our patient cohort, bariatric surgery leads to improvements in CKD markers, with a significant percentage of CKD remission.