Bariatric Surgery in Chronic Kidney Disease: Safety, Efficacy and Nutritional Considerations

The prevalence of obesity has increased, and simultaneously, there has been an increase in the prevalence of chronic kidney disease. Obesity is considered an independent risk factor for the incidence and progression of chronic kidney disease and is also associated with an increased risk of type 2 diabetes and hypertension, which are major causes of chronic kidney disease. Therefore, it is essential to prevent and treat obesity to reduce the incidence of chronic kidney disease and delay of its progression. Given the failure of weight loss through lifestyle modification, the hypothesis arises to submit chronic kidney patients with morbid obesity to bariatric surgery. However, considering the specific nutritional requirements of chronic kidney patients, doubts arise about the universal application of current guidelines for patients undergoing bariatric surgery. Thus, the present review aims to assess the safety and efficacy of bariatric surgery in the different stages of chronic kidney disease and the nutritional requirements of chronic kidney patients undergoing bariatric surgery. Through this review, it is possible to conclude that bariatric surgery can be considered for chronic kidney and transplant patients who fail in losing weight through other approaches. However, it is emphasized that randomized clinical trials and the development of guidelines are necessary to ensure proper nutritional management of chronic kidney and transplant patients undergoing bariatric surgery.