Bariatric Surgery Up in Patients With End-Stage Kidney Disease

For patients with end-stage kidney disease (ESKD), there has been an increase in bariatric surgery, with proportional use of laparoscopic sleeve gastrectomy increasing, according to a study published online July 25 in the Clinical Journal of the American Society of Nephrology.

Kyle H. Sheetz, M.D., from the University of Michigan in Ann Arbor, and colleagues identified all beneficiaries undergoing bariatric surgery in the United States between 2006 and 2016 using 100 percent Medicare data. Longitudinal practice patterns were evaluated using regression models.

The researchers found that there was a ninefold increase in the number of patients with ESKD undergoing bariatric surgery between 2006 and 2016. There was an increase in the proportional use of sleeve gastrectomy from <1 percent in 2006 to 84 percent in 2016. Similar complication rates were seen for sleeve gastrectomy among patients with and without ESKD (3.4 and 3.6 percent, respectively). Significantly more readmissions (8.6 and 5.4 percent, respectively) and slightly longer hospital stays (2.2 and 1.9 days, respectively) were seen for ESKD patients compared to those without ESKD.

"The findings from this study suggest that the medical community should focus on determining how best to use weight loss surgery as one tool in the long-term management of patients with kidney failure," Sheetz said in a statement. "It also highlights the potential for greater collaboration between primary care doctors, nephrologists, and surgeons."

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