Bariatric surgery and kidney disease

Bariatric surgery has emerged as an efficacious treatment for obesity and its comorbidities. Chronic kidney disease (CKD), similar to other comorbidities of obesity, improves with the significant and sustained weight loss resulting from bariatric surgery. In this chapter, specific obesity comorbidities are delineated, and the pathogenesis underlying these comorbidities is addressed. Indications for bariatric surgery along with descriptions of individual operations are discussed. Nutritional management recommendations after bariatric surgery, dependent on the bariatric operation performed, are given in the context of the added complexity of nutrition challenges in CKD. A review of bariatric surgery outcomes in general, and in the setting of CKD is covered. Current evidence for bariatric surgery in the overall management of transplant for end-stage kidney disease is also included. Finally, an assessment of factors considered in the cost/benefit analysis of bariatric surgery as a treatment is introduced.