Surgery Cuts Kidney Disease in Diabetes

Diabetic nephropathy in obese type 2 diabetes patients put into remission through bariatric surgery

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) In many cases, type 2 diabetes can be prevented or reversed through a healthy diet and exercise. When lifestyle changes don't do the trick, obese patients can turn to weight loss surgery.

Bariatric surgery, or weight loss surgery, can prevent or reduce diabetic nephropathy (diabetes-related kidney disease) among obese patients with type 2 diabetes.

"Ask your doctor about weight loss surgery."

Diabetic nephropathy is the main cause of end-stage renal disease - the complete, or almost complete, failure of kidney function.

"When we started the study, we thought bariatric surgery may just halt the progression of diabetic nephropathy," says Helen M. Heneghan, MD, of the Cleveland Clinic Bariatric and Metabolic Institute.

"[Instead,] over half of the patients who had diabetic nephropathy prior to undergoing bariatric surgery experienced remission. This is a remarkable finding that warrants greater consideration of bariatric surgery in this patient population," she says.

In the past couple decades, rates of diabetic kidney disease have increased by 34 percent. Today, about seven million Americans have diabetic kidney disease, which increases the risk of heart disease and death.

From their study of 52 obese patients with type 2 diabetes, Dr. Heneghan and colleagues found that almost 60 percent of obese patients with diabetic kidney disease no longer had the condition five years after surgery.

Diabetic kidney disease developed in only 25 percent of obese diabetes patients who did not have nephropathy when they went into surgery.

According to the researchers, the rate of new cases of nephropathy after surgery is about half that of diabetes patients who do not undergo surgery.

On top of putting kidney disease into remission and improving type 2 diabetes symptoms, patients who underwent surgery were able to maintain about half of their weight loss after five years.

Surgery patients also improved blood pressure and cholesterol levels.

Speaking of bariatric surgery, study co-author Philip R. Schauer, MD, also of the Cleveland Clinic, says, "No medical therapy has been as effective in achieving an effect of this magnitude on diabetic nephropathy."

The World Health Organization estimates that 90 percent of type 2 diabetes patients around the world are overweight or obese. In the United States, about 23.5 million people 20 years of age and older have type 2 diabetes.

According to the authors, these statistics highlight the importance of controlling obesity and diabetes.

The current study involved 52 obese patients with type 2 diabetes. Most of the participants were female. The most common bariatric surgery was gastric bypass surgery.

The results were presented at the 29th Annual Meeting of the American Society for Metabolic & Bariatric Surgery. The study has yet to be reviewed by a body of peers.

Reviewed by: 
Review Date: 
June 25, 2012
Last Updated:
November 27, 2012