The effectiveness and safety of bariatric surgery in individuals with end-stage renal disease: a systematic review and meta-analysis

Abstract

Abstract Objective Contentious debate remains regarding the suitability of bariatric surgery (BS) for patients with end-stage renal disease (ESRD). This study aimed to assess the eligibility and safety of BS in ESRD patients receiving kidney transplantation (KTX). Methods A comprehensive search of Embase, PubMed, Web of Science, and Cochrane Library databases was conducted to identify relevant literature on the outcomes of BS in patients with ESRD up to were searched up to July 31st, 2023. Results Seventeen studies were included and analyzed. The excess body weight loss (EWL) among patients with ESRD ranged from 32.1–82.0% following BS. Pooled analysis indicated that the listed for KTX rate [(95% confidential interval (CI)] was 83% (67%-95%), and the successful KTX rate (95% CI) was 57% (31%-80%). The mortality rate (95% CI) after BS was 0% (0%-0%), and the complication rate (95% CI) after BS was 7% (1%-15%). The mortality rate (95% CI) after KTX was 0% (0%-1%); meanwhile, the complication rate (95% CI) after KTX was 20% (10%-41%). Publication bias existed in the findings of listed for KTX, mortality after BS, and complication rates after KTX (all P < 0.05), whose significance still existed after adjustment by the trim and fill analysis, indicating the robustness of findings with publication bias was good. These findings would not be affected by publication bias to a certain extent. Conclusions BS for patients with ESRD is an effective means of reducing body weight, thereby increasing the likelihood of successful kidney transplantation with an acceptable safety profile.