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Author Topic: Reversal of ESRD through bariatric surgery
Tejas
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Post Reversal of ESRD through bariatric surgery
on: August 20, 2012, 15:35
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From: @ashartwit

Whats the mechanism of reversal of ESRD following bariatric surgery. saw two patients with this. @nephondemand @ecuimchiefs #ecuimres
Tejas
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Post Re: Reversal of ESRD through bariatric surgery
on: August 20, 2012, 15:43
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Great question. First, I need to clarify if the patient's ESRD was reversed because s/he qualified for a kidney transplant. Obesity is a relative contraindication for kidney transplantation and many patients who have failed to lose an appropriate amount of weight through conventional methods (exercise, diet) will undergo bariatric surgery to qualify for transplantation.

If this is not the case, then I need to clarify if the patient had CKD or ESRD. There is data to suggest that bariatric surgery can reverse both diabetes mellitus and diabetic nephropathy (though the latter is still new data and not yet vigorously studied). However, the patients studied in this investigation had diabetes-induced CKD, and not diabetes-induced ESRD (http://www.newswise.com/articles/cleveland-clinic-study-shows-high-remission-rates-of-diabetic-kidney-disease-five-years-after-bariatric-surgery). As far as I know, there is no reversal for End-Stage Renal Disease (it is truly End-stage).

Tejas
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Post Re: Reversal of ESRD through bariatric surgery
on: August 20, 2012, 15:54
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@nephondemand @renal @medicine
But whats the mechanism? reversal of diabetic nephropathy? #bariatric

Does that means diabetic nephropathy associated renal ultrastructural changes are reversible? @ashartwit @nephondemand @renal @medicine

Tejas
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Post Re: Reversal of ESRD through bariatric surgery
on: August 20, 2012, 16:15
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The mechanism is through the reversal of the effects of diabetes on the glomerulus. This suggests that at an ultrastructural level diabetic nephropathy can be reversed.
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Post Re: Reversal of ESRD through bariatric surgery
on: August 20, 2012, 19:13
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Thanks.
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