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Bariatric Surgery in patients with Kidney Failure: A Case Report

Eliana Al Haddad, Dr, Salman Al Sabah, Dr. Al Amiri Hospital

Introduction: While there are many criteria that are considered when selecting a patient for a kidney transplant, a BMI of over 35-45 kg/m2 is deemed the upper limit to consider evaluation. Whereas voluntary weight loss attempts are a major concern for the general population, for patients to attempt this while on hemodialysis is even more daunting. However, bariatric surgeries have opened up a new door to notable weight loss results, even demonstrating significant improvements of patients’ diabetic profile and hypertensive control.

Case Report: This is a case of a 52-year-old male, known to have type 1 diabetes mellitus as well as hypertension and hypothyroidism. The patient was in end-stage renal disease when the need for kidney transplant was determined. However, at that time his BMI was 42 making him ineligible to be placed on the waiting list.Therefore it was determined that a laparoscopic sleeve gastrectomy (LSG) should be performed in order to aid with his weight loss. He managed to lose the maximum amount of weight 6 months after surgery, reaching a BMI of 31.5kg/m2, also showing a major improvement in his hypertension and diabetes profiles. While the patient was being prepared for the kidney transplant, he started to show an increase in his weight as well as deterioration in his diabetic control. He underwent the renal transplant 1.5 years post LSG, after which he starting showing imporovements in his blood results, diabetic and hypertensive control. However, his weight began to increase once more, for which he consulted his surgeon that recommended gastric bypass surgery. Since the surgery, the patients' glucose, BUN and creatinine have normalized and his weight continued to drop, reaching a BMI of 32.99 kg/m2 2 years post bypass.

Conclusion: Bariatric surgeries have been shown to be safe and effective weight loss, as well as metabolic control options in renal failure patients.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 79502

Program Number: P172

Presentation Session: Poster (Non CME)

Presentation Type: Poster

76

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