Is Bariatric Surgery an Effective Treatment for Type II Diabetic Kidney Disease?

Type II diabetic kidney disease is devastating to patients and society alike. This review will evaluate bariatric surgery as a treatment for diabetic kidney disease primarily through its ability to induce and maintain regression of type II diabetes. The review begins by outlining the global challeng...

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Bibliographic Details
Published in:Clinical journal of the American Society of Nephrology 2016-03, Vol.11 (3), p.528-535
Main Authors: Friedman, Allon N, Wolfe, Bruce
Format: Article
Language:English
Subjects:
Bariatric Surgery - adverse effects
Bariatric Surgery - economics
Bariatric Surgery - mortality
Cost-Benefit Analysis
Diabetes Mellitus, Type 2 - economics
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - mortality
Diabetic Nephropathies - economics
Diabetic Nephropathies - epidemiology
Diabetic Nephropathies - mortality
Health Care Costs
Humans
Mini-Review
Obesity - economics
Obesity - mortality
Obesity - physiopathology
Obesity - surgery
Remission Induction
Risk Factors
Treatment Outcome
Weight Loss
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Summary:Type II diabetic kidney disease is devastating to patients and society alike. This review will evaluate bariatric surgery as a treatment for diabetic kidney disease primarily through its ability to induce and maintain regression of type II diabetes. The review begins by outlining the global challenge of diabetic kidney disease, its link to obesity, and the comparative benefits of bariatric surgery on weight and type II diabetes. It then surveys comprehensively the relevant literature, which reports that although bariatric surgery is associated with reductions in albuminuria, its effect on harder clinical end points like progression of diabetic kidney disease is not known. The review also includes a critical assessment of the risks and costs of bariatric surgery and concludes by acknowledging the major knowledge gaps in the field and providing research strategies to overcome them. Until these knowledge gaps are filled, clinicians will be forced to rely on their own subjective judgment in determining the benefit-risk ratio of bariatric surgery for patients with diabetic kidney disease.
ISSN:1555-9041
1555-905X
DOI:10.2215/CJN.07670715