Conference of the Nephropathy Committee of the Argentine Society of Diabetes. Bariatric surgery update in a patient with diabetes and kidney disease. Part 1

Authors

  • Alicia Elbert Center for Renal Diseases and Arterial Hypertension (CERHA S.A.), Autonomous City of Buenos Aires, Argentina
  • Susana Gutt Italian Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Estrella Menéndez Center for Medical Education and Clinical Research "Norberto Quirno" (CEMIC), Autonomous City of Buenos Aires, Argentina
  • María Florencia Aranguren José de San Martín Clinical Hospital, Autonomous City of Buenos Aires, Argentina
  • Bárbara Arinovich Cabildo and Céspedes Private Offices, Autonomous City of Buenos Aires, Argentina
  • Teresa Bensusan Cepem Medical Center, Morón, Province of Buenos Aires, Argentina
  • Guillermo De?Marziani Center for Renal Diseases and Arterial Hypertension (CEREHA S.A.), Province of Buenos Aires, Argentina
  • Guillermo Dieuzeide Nuestra Señora del Carmen Hospital, Chacabuco, Province of Buenos Aires, Argentina
  • Gabriela Medek Finochietto Sanatorium, Autonomous City of Buenos Aires, Argentina
  • Liliana Miriam Obregón Center of the Province of Buenos Aires (CUCAIBA-CRAI Sur-HIGA), Hospital General San Martín de La Plata, Province of Buenos Aires, Argentina
  • María José Pomares Clinics of the Center for Renal Diseases and Arterial Hypertension (CEREHA S.A.), Autonomous City of Buenos Aires, Argentina
  • María Jimena Soutelo Hospital Churruca Visca, Autonomous City of Buenos Aires, Argentina
  • Fabiana Vázquez British Hospital, Vicente Lopéz headquarters, Buenos Aires Province, Argentina
  • Gloria Viñes Private Community Hospital, Mar del Plata, Province of Buenos Aires, Argentina
  • Mariela Volta University of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Fabiana Dávila Austral University Hospital, Pilar, Province of Buenos Aires, Argentina
  • Yanina Castaño CETRO Dialysis Center (Center for Renal Studies and Treatment Olavarría), Province of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v55i2.478

Keywords:

obesity, diabetes, bariatric surgery, metabolic surgery, chronic kidney disease, focal and segmental glomerulopathy

Abstract

The prevalence of obesity and diabetes mellitus are associated with the development of chronic kidney disease and its terminal stages. In individuals affected by obesity, a probably compensatory hyperfiltration mechanism occurs to satisfy the high metabolic demand associated with increased body weight; it is also associated with the presence and development of proteinuria in individuals without kidney disease. Histopathology shows obesity-related focal and segmental glomerulosclerosis in a setting of glomerulomegaly. Metabolic surgery is the most effective means of obtaining substantial and lasting weight loss. The superiority of surgery over medical treatment has been demonstrated only to achieve better glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms appear to extend beyond the magnitude of weight loss and include improvements in incretin profiles, insulin secretion, and insulin sensitivity.

The Nephropathy Committee of the Argentine Diabetes Society carried out this review on mechanisms involved in obesity as a cause of kidney disease or worsening of kidney disease due to diabetes, the mechanisms by which bariatric surgery would benefit patients with diabetes and kidney disease chronic and its terminal stages, the pre and post-surgical controls that should be performed by patients undergoing this type of surgery.

Author Biographies

Alicia Elbert, Center for Renal Diseases and Arterial Hypertension (CERHA S.A.), Autonomous City of Buenos Aires, Argentina

Medical specialist in Nephrology, specialized in Diabetes; Director of the Center for Renal Diseases and Arterial Hypertension (CERHA S.A.)

Susana Gutt, Italian Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina

Nutrition Specialist; Head of Nutrition Section

Estrella Menéndez, Center for Medical Education and Clinical Research "Norberto Quirno" (CEMIC), Autonomous City of Buenos Aires, Argentina

Specialist in Nutrition

María Florencia Aranguren, José de San Martín Clinical Hospital, Autonomous City of Buenos Aires, Argentina

Medical specialist in Internal Medicine, specialized in Diabetes

Bárbara Arinovich, Cabildo and Céspedes Private Offices, Autonomous City of Buenos Aires, Argentina

Specialist in Internal Medicine and Nutrition

Teresa Bensusan, Cepem Medical Center, Morón, Province of Buenos Aires, Argentina

Medical specialist in Internal Medicine, specialized in Diabetes

Guillermo De?Marziani, Center for Renal Diseases and Arterial Hypertension (CEREHA S.A.), Province of Buenos Aires, Argentina

Medical specialist in Internal Medicine, Specialist in Nephrology and Master in Diabetes

Guillermo Dieuzeide, Nuestra Señora del Carmen Hospital, Chacabuco, Province of Buenos Aires, Argentina

Doctor of Medicine, Specialist in Endocrinology; Head of the Endocrinology and Diabetes Service

Gabriela Medek, Finochietto Sanatorium, Autonomous City of Buenos Aires, Argentina

Internal Medicine specialist, specialized in Diabetes

Liliana Miriam Obregón, Center of the Province of Buenos Aires (CUCAIBA-CRAI Sur-HIGA), Hospital General San Martín de La Plata, Province of Buenos Aires, Argentina

Consultant specialist in Endocrinology; Head of the Renal Transplant Area

María José Pomares, Clinics of the Center for Renal Diseases and Arterial Hypertension (CEREHA S.A.), Autonomous City of Buenos Aires, Argentina

Specialist in Nephrology and specialized in Diabetes

María Jimena Soutelo, Hospital Churruca Visca, Autonomous City of Buenos Aires, Argentina

Endocrinologist, specialized in Diabetes

Fabiana Vázquez, British Hospital, Vicente Lopéz headquarters, Buenos Aires Province, Argentina

Nutrition specialist, specialized in Diabetes

Gloria Viñes, Private Community Hospital, Mar del Plata, Province of Buenos Aires, Argentina

Nutrition specialist, specialized in Diabetes; Head of the Nutrition and Diabetes Service

Mariela Volta, University of Buenos Aires, Autonomous City of Buenos Aires, Argentina

Bachelor in Nutrition

Fabiana Dávila, Austral University Hospital, Pilar, Province of Buenos Aires, Argentina

Nutrition Specialist

Yanina Castaño, CETRO Dialysis Center (Center for Renal Studies and Treatment Olavarría), Province of Buenos Aires, Argentina

Specialist in Nutrition, Magister in Diabetes; Coordinator of the Diabetes Area

References

I. Kovesky CP, Furth SL, Zoccoli C. Obesity and kidney disease: hidden consequences of the epidemic. Canadian Journal of Kidney Health and Disease 2017; (4):1-10.

II. Organización Mundial de la Salud. 16 de febrero de 2018. Obesidad y sobrepeso.

III. Cuarta Encuesta Nacional de los Factores de Riesgo. Dirección Nacional de la Promoción de la Salud y control de Enfermedades Crónicas no Transmisibles. Principales resultados. 2018. Disponible en: https://bancos.salud.gob.ar/sites/default/files/2020-01/4ta-encuesta-nacional-factores-riesgo_2019_principales-resultados.pdf.

IV. Foster MC, Hwang SJ, Larson MG, et al. Overweight, obesity, and the development of stage 3 CKD: the Framingham Heart Study. Am J Kidney Dis 2008 Jul; 52(1):39-48.

V. Wang Y, Chen X, Song Y, et al. Association between obesity and kidney disease: a systematic review and meta-analysis. Kidney Int 2008 Jan; 73(1):19-33.

VI. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030.PLoS Med 2006; 3(11):e442.

VII. Subramanian SV, Perkins JM, Özaltin E, et al. Weight of nations: a socioeconomic analysis of women in low- to middle-income countries. Am J Clin Nutr 2011; 93(2):413-421.

VIII. Tsujimoto T, Sairenchi T, Iso H, et al. The dose-response relationship between body mass index and the risk of incident stage ≥3 chronic kidney disease in a general Japanese population: the Ibaraki prefectural health study (IPHS). J Epidemiol 2014; 24(6):444-451.

Published

2021-08-02

How to Cite

Elbert, A., Gutt, S., Menéndez, E., Aranguren, M. F., Arinovich, B., Bensusan, T., De?Marziani, G., Dieuzeide, G., Medek, G., Obregón, L. M., Pomares, M. J., Soutelo, M. J., Vázquez, F., Viñes, G., Volta, M., Dávila, F., & Castaño, Y. (2021). Conference of the Nephropathy Committee of the Argentine Society of Diabetes. Bariatric surgery update in a patient with diabetes and kidney disease. Part 1. Journal of the Argentine Society of Diabetes, 55(2), 52–69. https://doi.org/10.47196/diab.v55i2.478

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Conferences

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