{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:36:29Z","timestamp":1778632589653,"version":"3.51.4"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004700","name":"Taipei Medical University","doi-asserted-by":"publisher","award":["106TMU\u2010AE1\u2010B19"],"award-info":[{"award-number":["106TMU\u2010AE1\u2010B19"]}],"id":[{"id":"10.13039\/501100004700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Weight\u2010reduction therapies, including bariatric surgery (BS), are standard treatments for severely obese patients with type 2 diabetes; however, the outcomes of these therapies are inconclusive for obese patients with chronic kidney disease (CKD). This study aimed to investigate the effects of BS or non\u2010surgical interventions on the estimated glomerular filtration rate (eGFR) and to determine whether BS can be recommended for renal function preservation based on body mass index (BMI) and eGFR changes in obese patients with CKD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study used data from the weight Reduction Intervention on GFR in Obese Patients with Renal Impairment\u2010Taipei Medical University (TMU) study, which was a large, long\u2010term, propensity score\u2010matched cohort study based on clinical data from patients who registered at weight\u2010reduction centres at TMU and its affiliated hospitals from 2008 to 2016. The patients were stratified according to whether they had undergone BS and into the mild, moderate, and high CKD risk groups using the Kidney Disease: Improving Global Outcomes guidelines. The primary outcome was the eGFR calculated using the Taiwan Chronic Kidney Disease\u2010Epidemiology Collaboration equation. Cox regression models were used to determine hazard ratios (HRs) for eGFR decreases \u226525%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 4332 obese patients were enrolled in this study. After propensity score matching, 1620 patients, including 60.2% women, with a mean age of 36.5 (9.9) years were divided into BS or non\u2010surgery groups (<jats:italic>n<\/jats:italic> = 810 per group). The overall mean eGFRs increased by 4.4 (14) mL\/min\u00b71.73 m<jats:sup>2<\/jats:sup> and decreased by 6.4 (16.0) mL\/min\u00b71.73 m<jats:sup>2<\/jats:sup> in the BS and non\u2010surgery groups, respectively. The decrease in BMI in the BS and non\u2010surgery groups were 2.5 and 1.3 kg\/m<jats:sup>2<\/jats:sup>, respectively. In the moderate\/high CKD risk BS group, a significant correlation was evident between an increased eGFR and a reduced BMI (Spearman's correlation \u22120.229, <jats:italic>P<\/jats:italic> &lt; 0.001). The Cox regression analysis showed that the BS group had a significantly lower risk of an eGFR decline \u226525% at 12 months [adjusted HR (aHR) 0.47, <jats:italic>P<\/jats:italic> = 0.03). After BS, obese patients with hypertension or albuminuria had significantly lower risks of eGFR declines \u226525% (aHR 0.37, <jats:italic>P<\/jats:italic> = 0.02 and aHR 0.13, <jats:italic>P<\/jats:italic> = 0.0018, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bariatric surgery was associated with eGFR preservation in all obese patients and, particularly, in those with moderate\u2010to\u2010high CKD risks. A longer term outcome study is warranted to determine the benefits of BS for CKD patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12423","type":"journal-article","created":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T09:45:57Z","timestamp":1554198357000},"page":"756-766","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Effect of weight loss on the estimated glomerular filtration rates of obese patients at risk of chronic kidney disease: the <scp>RIGOR<\/scp>\u2010<scp>TMU<\/scp> study"],"prefix":"10.1002","volume":"10","author":[{"given":"Yen\u2010Chung","family":"Lin","sequence":"first","affiliation":[{"name":"Graduate Institute of Clinical Medicine, School of Medicine, College of Medine Taipei Medical University  Taipei Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine Taipei Medical University Hospital  Taipei Taiwan"},{"name":"Department of Internal Medicine, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010Jen","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine Taipei Medical University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010Chun","family":"Lin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Division of Endocrinology and Metabolism, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiung\u2010Chi","family":"Peng","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Medicine, School of Medicine, College of Medine Taipei Medical University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuan\u2010Chou","family":"Chen","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Medicine, School of Medicine, College of Medine Taipei Medical University  Taipei Taiwan"},{"name":"Division of Urology Taipei Medical University\u2010Shuang Ho Hospital  New Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming\u2010Tsang","family":"Chuang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Informatics, College of Medical Science and Technology Taipei Medical University  Taipei Taiwan"},{"name":"Office of Information Technology Taipei Medical University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mai\u2010Szu","family":"Wu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Medicine, School of Medicine, College of Medine Taipei Medical University  Taipei Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine Taipei Medical University\u2010Shuang Ho Hospital  New Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzu\u2010Hao","family":"Chang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Informatics, College of Medical Science and Technology Taipei Medical University  Taipei Taiwan"},{"name":"Clinical Big Data Research Center Taipei Medical University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,2]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"World Health Organization.Fact sheet No 311 Obesity and overweight: World Health Organization.2015. http:\/\/www.who.int\/mediacentre\/factsheets\/fs311\/en\/. 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