Author's response: Because of the nature of obesity, the impact of adiposity on the major organs including the kidneys, and numerous comorbid conditions, acute kidney injury can occur among obese patients having surgery. In one study that examined patients having weight loss surgery, as many as 8.5% of patients either developed or had a history of acute kidney injury. Risk factors included higher body mass index, hyperlipidemia, and use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.1

A critical component to success is long-term follow-up: not just until the incisions are healed or even for a few years, but for life. This includes regularly scheduled lab tests, exams, and counseling, and requires a collaborative relationship between the patient's primary care provider and weight loss surgeon.

It's unrealistic to think that any medical or surgical procedure is without risk. The weight loss surgery team must clearly communicate the risks and benefits to each patient so that she can make an informed decision.

-SUSAN GALLAGHER CAMDEN, RN, CBN, MA, MSN, PhD

1. Thakar CV, Kharat V, Blanck S, Leonard AC. Acute kidney injury after bypass surgery. Clin J Am Soc Nephrol. 2007;2(3):426-430. [Context Link]