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Effect of Roux-en-Y gastric bypass and diet-induced weight loss on diabetic kidney disease in the Zucker diabetic fatty rat

Journal article
Authors Karl J. Neff
Jessie A. Elliott
Caroline Corteville
Kathrin Abegg
Camilo Boza
Thomas A. Lutz
Neil G. Docherty
Carel W le Roux
Published in Surgery for Obesity and Related Diseases
Volume 13
Pages 21-27
ISSN 1550-7289
Publication year 2017
Published at Institute of Clinical Sciences, Department of Gastrosurgical Research and Education
Pages 21-27
Language en
Links doi.org/10.1016/j.soard.2016.08.026
Keywords Bariatric, Diabetic kidney disease, Gastric bypass, Renal inflammation, RYGB, Urinary protein excretion, Weight loss, Zucker diabetic fatty rat
Subject categories Diabetology, Endocrine surgery

Abstract

© 2017 American Society for Bariatric Surgery Background Reductions in urinary protein excretion after Roux-en-Y gastric bypass (RYGB) surgery in patients with diabetic kidney disease have been reported in multiple studies. Objectives To determine the weight loss dependence of the effect of RYGB on urinary protein excretion by comparing renal outcomes in Zucker diabetic fatty rats undergoing either gastric bypass surgery or a sham operation with or without weight matching. Setting University laboratories. Methods Zucker diabetic fatty rats underwent surgery at 18 weeks of age. A subgroup of sham operated rats were weight matched to RYGB operated rats by restricting food intake. Urinary protein excretion was assessed at baseline and at postoperative weeks 4 and 12. Renal histology and macrophage-associated inflammation were assessed at postoperative week 12. Results Progressive urinary protein excretion was attenuated by both RYGB and diet-induced weight loss, albeit to a lesser extent by the latter. Both weight loss interventions produced equivalent reductions in glomerulomegaly, glomerulosclerosis, and evidence of renal macrophage infiltration. Conclusion Weight loss per se improves renal structure and attenuates renal inflammatory responses in an experimental animal model of diabetic kidney disease. Better glycemic control post-RYGB may in part explain the greater reductions in urinary protein excretion after gastric bypass surgery.

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