Bariatric Surgery and Chronic Renal Disease

Summary

Obesity can be a major driver for the development of chronic kidney disease (CKD), which is a leading cause of death and significant loss in quality of life. A growing body of evidence has shown bariatric (metabolic) surgery as a novel approach to reduce the progression of CKD and reduce morbidity with sustained weight loss. This pilot trial will inform the design and execution of a large RCT that could determine the efficacy of bariatric surgery in the treatment of patients with CKD in the context of obesity. Ultimately, the results have the potential to influence guidelines that may deem bariatric surgery as a viable treatment option for CKD and reduce the morbidity from this chronic condition and inform clinical practice.

Conditions

• Bariatric Surgery
• Chronic Kidney Diseases
• Obesity

Interventions

PROCEDURE

Bariatric Surgery + Medical Management of CKD.

The intervention group will include medical management and bariatric surgery, which will consist of Roux-en-Y gastric bypass or sleeve gastrectomy performed according to local practice standards. Medical management for CKD will be directed by nephrologists at St. Joseph's Healthcare Hamilton. Comorbidities such as hypertension, dyslipidemia, and type 2 diabetes will be managed at the discretion of individual nephrologists. Generally, this can include anti-hypertensives (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) for systolic blood pressure control below a target of \<140/90 mmHg (\<130/80 in patients with type 2 diabetes), statins in patients with dyslipidemia to target low-density lipoprotein \<2mmol/L for the treatment of CKD.

OTHER

Medical Management for CKD

Medical management for CKD will be directed by nephrologists at St. Joseph's Healthcare Hamilton. Comorbidities such as hypertension, dyslipidemia, and type 2 diabetes will be managed at the discretion of individual nephrologists. Generally, this can include anti-hypertensives (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) for systolic blood pressure control below a target of \<140/90 mmHg (\<130/80 in patients with type 2 diabetes), statins in patients with dyslipidemia to target low-density lipoprotein \<2mmol/L for the treatment of CKD.

Sponsors & Collaborators

• American College of Surgeons

  collaborator OTHER

• McMaster Surgical Associates

  collaborator OTHER

• McMaster University

  lead OTHER

Principal Investigators

• Dennis Hong, MD MSc FRCSC · McMaster University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-04-01

Primary Completion

2023-05-01

Completion

2023-06-01

Countries

• Canada

Study Locations