Evidence mapPaperPMID 29568103Full record

ArticleInternational journal of obesity (2005)2018

Incidence of end-stage renal disease following bariatric surgery in the Swedish Obese Subjects Study.

A Shulman, M Peltonen, C D Sjöström, J C Andersson-Assarsson, M Taube, K Sjöholm, C W le Roux, L M S Carlsson, P-A Svensson

Registry-linked trialAbstract read
In one paragraph

Article in International journal of obesity (2005), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04626323 (Open, Randomized, Unicenter Study Comparing Metabolic Surgery With Intensive Medical Therapy to Treat Diabetic Kidney Disease), which is not on this map. Cited by 37 papers.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed
10.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04626323 phase2unknown statusnot on this mapstarted 2021, after this paper: background citation

Open, Randomized, Unicenter Study Comparing Metabolic Surgery With Intensive Medical Therapy to Treat Diabetic Kidney Disease

TypeinterventionalSponsorHospital Alemão Oswaldo CruzRan2021 to 2024Enrolled60ConditionsDiabetes Mellitus, Type 2, Kidney Disease, Chronic, Kidney InjuryArmsRoux-en-Y gastric bypass, Best medical treatment
3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 82 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Prevalence and risk factors of acute kidney injury in adults with obesity undergoing bariatric surgery: a systematic review and meta-analysis.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2026
    Review
  5. Review
  6. Article
  7. Article
  8. Obesity-Related Glomerulosclerosis-How Adiposity Damages the Kidneys.International journal of molecular sciences · 2025
    Review
  9. Obesity and Metabolic Health in CKD.Clinical journal of the American Society of Nephrology : CJASN · 2025
    Review
  10. Review
  11. Article
  12. Review
  13. Review
  14. Article
  15. Review
  16. Review
  17. Review
  18. Review
  19. Review
  20. Bariatric Surgery and Hypertension.Journal of clinical medicine · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 4 countries.

A ShulmanDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
M PeltonenChronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.ORCID http://orcid.org/0000-0002-3767-4223
C D SjöströmGlobal Medicines Development, Cardiovascular and Metabolic Disease, AstraZeneca, Gothenburg, Sweden.
J C Andersson-AssarssonDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0000-0001-9082-8589
M TaubeDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
K SjöholmDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0000-0003-0146-8193
C W le RouxDiabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland.
L M S CarlssonDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
P-A SvenssonDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. per-arne.svensson@medic.gu.se.ORCID http://orcid.org/0000-0002-6731-806X
University of Gothenburg · SEAstraZeneca (Sweden) · SEFinnish Institute for Health and Welfare · FIUniversity College Dublin · IE

Funding

NIDDK NIH HHS R01 DK105948
6 · The paper itself

Abstract

backgroundObesity is a major public health problem leading to co-morbidities such as diabetes, hypertension and kidney failure. Bariatric surgery results in pronounced and maintained weight loss and prevention of obesity-related diseases and their complications. Most studies of bariatric surgery on kidney disease show improvements after surgery. However, long-term studies analyzing hard end-points are lacking. Here we report on the long-term effects of bariatric surgery compared to usual obesity care on incidence of end-stage renal disease (ESRD) alone and in combination with chronic kidney disease stage 4 (CKD4/ESRD).

methods4047 patients were included in the Swedish Obese Subjects (SOS) study. Inclusion criteria were age 37-60 years and BMI ≥ 34 in men and BMI ≥ 38 in women. Patients in the bariatric surgery group (N = 2010) underwent banding (18%), vertical banded gastroplasty (69%), or gastric bypass (13%); controls (N = 2037) received usual obesity care. In this analysis, patients were followed up for a median time of 18 years. The incidence of ESRD and CKD4 was obtained by crosschecking the SOS database with the Swedish National Patient Register.

resultsDuring follow-up, ESRD occurred in 13 patients in the surgery group and in 26 patients in the control group (adjusted hazard ratio (HR) = 0.27; 95% CI 0.12-0.60; p = 0.001). The number of CKD4/ESRD events was 23 in the surgery group and 39 in the control group (adjusted HR = 0.33; 95% CI 0.18-0.62; p < 0.001). In both analyses, bariatric surgery had a more favorable effect in patients with baseline serum insulin levels above median compared to those with lower insulin levels (interaction p = 0.010). Treatment benefit of bariatric surgery was also greater in patients with macroalbuminuria at baseline compared to those without macroalbuminuria (interaction p < 0.001).

conclusionsOur study showed for the first time that bariatric surgery is associated with a long-term protection against ESRD and CKD4/ESRD.

Indexed as

AdultBariatric SurgeryFemaleHumansKidney Failure, ChronicMaleMiddle AgedObesityPostoperative ComplicationsSweden

Identifiers

PMID29568103
PMCPMC6019553
OpenAlexW2789862618

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.