Bariatric Surgery Can Resolve Diabetic Nephropathy

A recent study proved that bariatric surgery not only improves type 2 diabetes, but can resolve diabetes-related kidney disease in obese patients.

“When we started this study, we thought bariatric surgery may just halt the progression of diabetic nephropathy, instead over half of the patients who had diabetic nephropathy prior to undergoing bariatric surgery experienced remission,” said Dr. Helen M. Heneghan, lead author of the study and bariatric surgery fellow at the Cleveland Clinic Bariatric and Metabolic Institute in Ohio, in a press briefing.

She added, “This is a remarkable finding that warrants greater consideration of bariatric surgery in this patient population.”

The study followed 52 patients who had suffered from obesity and diabetes for about nine years. Three-quarters of the patients were women, and the mean age was 51 . Of the study participants, 69 percent had gastric bypass surgery, 25 percent had laparoscopic gastric banding, and 6 percent had the sleeve gastrectomy procedure. All surgeries were performed at the Cleveland Clinic Bariatric and Metabolic Institute.

Initially, 40 percent of the study participants had diabetic nephropathy, which is a diabetic complication that causes uncontrollable blood sugar levels, and can lead to dialysis and kidney failure. Five years after their surgery, 60 percent of obese patients with diabetic nephropathy no longer had the condition.

In addition, researchers found that 44 percent of patients had sustained remission of their type 2 diabetes, 33 percent had a significant improvement, and 23 percent had no change or worsening of their disease. Patients who saw no change in their diabetes were those who had had type 2 diabetes the longest amount of time prior to the surgery.

Diabetes is the leading cause for kidney disease, which can substantially increase the risk of heart disease and death. Despite the medical community’s continuous efforts to prevent diabetic kidney disease, the rate has increased 34 percent over the last 20 years, and today, 7 million Americans suffer from the condition. In the U.S., diabetic nephropathy accounts for 40 percent of end stage renal disease.

“No medical therapy has been as effective in achieving an effect of this magnitude on diabetic nephropathy,” said Philip R. Schauer, the study’s co-author and is a professor of surgery and director of the Cleveland Clinic Bariatric and Metabolic Institute.

Study findings were presented last month at the 29th annual meeting of the American Society for Metabolic and Bariatric Surgery.