Camila Ortiz Gomez, MD, David Romero Funes, MD, David Gutierrez Blanco, MD, Joel S Frieder, MD, Maria Fonseca Mora, MD, Cristian Milla Matute, MD, Emanuele Lo Menzo, MD, PhD, FACS, FASMBS, Samuel Szomstein, MD, FACS, FASMBS, Raul Rosenthal, MD, FACS, FASMBS. Cleveland Clinic Florida
INTRODUCTION: Hypertension (HTN) is one of the most important risk factors for the development and progression of chronic kidney disease (CKD). Laparoscopic bariatric procedures have proven to have a positive impact in the blood pressure levels of Hypertensive patients. The aim of our study is to assess the prevalence of HTN in patients with CKD after undergoing laparoscopic bariatric surgery.
METHODS: We retrospectively reviewed all patients who underwent Laparoscopic Bariatric surgery at our institution from 2010-2017. We used the guidelines of the American College of Cardiology (ACC) to define HTN. Only patients who met the criteria for the ACC and the calculation of the estimated glomerular filtration rate (eGFR) using the CKD Epidemiology collaboration study equation (CKD-EPI) pre-operatively and at 12 months follow-up were included.
RESULTS: From 2900 patients, 29.13%(845) met the required variables for the calculation of eGFR pre-operatively. Of this patient population, 36.92%(312) had preoperative HTN and was classified as CKD stage ≥2. We observed a predominantly female population 63.83%(203) with a mean age of 54.10±11.58. Patients preoperatively classified in CKD stages 2, 3a and 3b, exhibited the grates prevalence reduction of HTN at 12 follow up (68.59%(214) vs 36.59%(114), 16.67%(52) vs 6.41%(20), 7.69%(24) vs 1.28%(4); p= <0.0001). A marked improvement in CKD was also observed along the improvement in HTN, with the greatest benefit corresponding to patients classified preoperatively in CKD stage 2 and 3a. From this population, 48.57%(34) patients who had HTN were classified in CKD Stage 2 compared to 19.72%(14) at 12 months follow up (p=0.0215) and 45.71(32) patients regained normal kidney function (p=0.0534). Additionally, 63.64%(14) patients who had HTN were classified as Stage 3a preoperatively, compared to 7.69%(2) at 12 months follow up (p=0.1466), and 3.85%(1) regained normal kidney function (p=0.0045).
CONCLUSIONS: Laparoscopic bariatric surgery procedures significantly reduce the prevalence of HTN in all stages of CKD at 12 months follow up. Additionally, there was a positive impact on the classification of CKD at 12 months follow up.
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Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95440
Program Number: S125
Presentation Session: Bariatric IV – Quality and Outcomes
Presentation Type: Podium