Study reveals that obesity surgery is superior to Ozempic in protecting the kidneys

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A study from the Cleveland Clinic in the United States showed that patients with type 2 diabetes, obesity and chronic kidney disease who underwent bariatric surgery showed a significant reduction in the progression of chronic kidney disease compared to patients who received diabetes medications of the GLP-1 agonist type, such as the drug semaglutide, known by the brand name Ozempic.

chronic kidney disease

Chronic kidney disease is a long-term kidney disease that can lead to kidney failure. The kidneys filter waste from the blood, and when the kidneys start to fail, waste can build up. Some people need dialysis, which is a process of filtering the blood through a machine.

“Our study shows that bariatric surgery can protect the kidneys and prevent kidney function from deteriorating,” said Dr. Ali Aminian, lead author of the study and director of the Obesity and Metabolic Disease Institute at the Cleveland Clinic, according to EurekAlert. “In patients with obesity and type 2 diabetes who already have chronic kidney disease, bariatric surgery can change the course of the disease.”

Bariatric surgery

Bariatric surgery is also known as weight loss surgery. These terms are used to reflect the effect these procedures have on patients’ weight. In addition to treating obesity, these procedures are very effective in treating diabetes, high blood pressure, sleep apnea, high cholesterol, and many other conditions. These procedures also have the ability to prevent future health problems. This surgery helps obese patients enjoy a better quality of life and a longer life.

The study, published in the Annals of Surgery on September 1, included 425 adult patients (aged 18 to 75) suffering from type 2 diabetes, obesity, and chronic kidney disease in stage 3 or 4.

Of the participants, 183 patients underwent bariatric surgery while 242 were treated with GLP-1 agonists. GLP-1 agonists mimic a hormone that regulates hunger called glucagon-like peptide-1, also known as GLP-1, which increases feelings of fullness and lowers blood sugar levels.

Patients in the study underwent bariatric surgery between 2010 and 2017 or continued to receive FDA-approved GLP-1 agonists that were available during the study period. In the non-surgical group, the most commonly prescribed GLP-1 agonists were liraglutide and exenatide.

During follow-up, 20% of patients in the non-surgical group received newer GLP-1 agonists such as semaglutide or tirzepatide at some point.

Results

Researchers found that bariatric surgery can protect kidney function and reduce the risk of kidney failure or death in patients. The study results showed that bariatric surgery was associated with a 60% lower risk of kidney disease progression and a 44% lower risk of kidney failure or death compared with the non-surgical group.

Over the 8-year study period, researchers found that 22 percent of participants in the surgical group experienced progression of kidney disease, compared with 45 percent in the nonsurgical group. Additionally, 24 percent of participants in the surgical group developed kidney failure or died during the 7-year study period, compared with 44 percent in the nonsurgical group.

Participants who underwent bariatric surgery experienced greater weight loss and better diabetes control. They also needed fewer medications to control diabetes, high blood pressure, and high cholesterol.

“Despite the significant benefits of bariatric surgery in protecting the kidneys, it is still underused in clinical practice,” said Dr. Aminian. “In current CKD management guidelines, maintaining a healthy weight through lifestyle changes is recommended, but bariatric surgery has not been considered as an option.”

“These numbers are encouraging and show that bariatric surgery should be considered as a treatment option for patients with chronic kidney disease and obesity,” added Dr. Jonathan Taliercio, a nephrologist at the Cleveland Clinic and co-author of the study.