Bariatric surgery slashes risk of kidney failure, heart attack and death, new data show

Metabolic and bariatric surgery, also known as weight-loss surgery, dramatically improves outcomes for patients with obesity and chronic kidney disease (CKD), significantly reducing the risk of kidney failure, major cardiovascular events and death, according to new research* presented here today at the annual meeting of the American Society for Metabolic and Bariatric Surgery.

CKD Patients who had metabolic and bariatric surgery cut their risk in half for developing end stage kidney disease (5.9% vs. 11.9%), were about 60% less likely to need dialysis (4.1% vs. 9%) and more than twice as likely to receive a kidney transplant, 4.6% vs. 2.2%. Heart attack and stroke risk also dropped by nearly half (15.5% vs. 27.7%), and the mortality rate plummeted by over 75% (5% vs. 16%).

In the real-world analysis of more than 8,900 patients with obesity and CKD, researchers compared the five-year outcomes of patients who had either sleeve gastrectomy or Roux-en-Y gastric bypass to patients of similar health status who did not have surgery. Data from 2010 to 2020 was obtained from the TriNetX Research Network electronic health record database.

“These findings show metabolic and bariatric surgery doesn’t just treat obesity, it fundamentally alters the course of chronic kidney disease and should be considered earlier in the disease process,” said lead study author Jerry Dang, MD, PhD, FRCSC, FACS, FASMBS, Associate Professor of Surgery at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. “With earlier intervention, we see slower disease progression, fewer patients advancing to kidney failure, better cardiovascular outcomes and greater access to life-saving transplants.”

CKD affects about 35.5 million Americans or about 1 in 7 adults, according to the U.S. Centers for Disease Control and Prevention (CDC), and is a leading cause of death in the United States. Obesity, diabetes, and hypertension are primary risk factors for the disease.

“The survival benefit of surgery patients observed in this study is extraordinary but not surprising,” said Richard M. Peterson, MD, MPH, FASMBS, President, ASMBS, who was not involved in the study. “These procedures are not simply about weight loss, they’re about changing the trajectory of chronic disease, preserving organ function and saving lives.”