{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T20:06:34Z","timestamp":1785355594244,"version":"3.55.0"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Science &amp;amp; Practice"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Obesity is associated with an increased risk of chronic kidney disease. Metabolic and bariatric surgery (MBS) is currently the most effective intervention for sustained weight loss and may reduce the risk of obesity\u2010associated kidney disease. This study examined the relationships between MBS and adverse kidney outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort analysis included 4322 patients with obesity, with or without type 2 diabetes mellitus (T2D), who underwent MBS, and 30,919 nonsurgical control patients from a large health system within the state of Indiana. A primary kidney composite [\u2265\u00a01 estimated glomerular filtration rate (eGFR)\u00a0&lt;\u00a015\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      , \u2265\u00a01 eGFR measurement with a \u2265\u00a040% decrease from baseline, or kidney failure\u2010related death], as well as secondary and tertiary composite and individual outcomes were assessed. Multivariable Cox regression models with and without inverse propensity of treatment weighting were employed to assess associations between MBS and incidence rate for each kidney outcome compared with nonsurgical controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean (standard deviation) follow\u2010up duration was 6.1 (4.5) years. MBS was associated with a 53% (HR: 0.47; 95% CI: 0.42, 0.52;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and 48% (HR: 0.52; 95% CI: 0.46, 0.60;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) lower incidence of the primary kidney composite outcome in patients with and without T2D, respectively, and 48%\u201356% lower risks for the secondary and tertiary outcomes, regardless of T2D status, compared to controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MBS was associated with markedly lower risks for adverse kidney outcomes in patients with obesity. These results support the potential for MBS as a weight loss intervention to preserve kidney function in patients with obesity, both with and without T2D.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/osp4.70109","type":"journal-article","created":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T17:40:23Z","timestamp":1766943623000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Relationships Between Metabolic and Bariatric Surgery and Adverse Kidney Outcomes: An Analysis of a Retrospective Cohort"],"prefix":"10.1002","volume":"11","author":[{"given":"Kevin C.","family":"Maki","sequence":"first","affiliation":[{"name":"Midwest Biomedical Research  Addison Illinois USA"},{"name":"Department of Applied Health Science School of Public Health Indiana University\u2010Bloomington  Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Dickinson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health Indiana University\u2010Bloomington  Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol F.","family":"Kirkpatrick","sequence":"additional","affiliation":[{"name":"Midwest Biomedical Research  Addison Illinois USA"},{"name":"Kasiska Division of Health Sciences Idaho State University  Pocatello Idaho USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongming","family":"Qu","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vipin","family":"Arora","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiwei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health Indiana University\u2010Bloomington  Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailey","family":"Ortyl","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health Indiana University\u2010Bloomington  Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas P.","family":"Landsittel","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Public Health and Health Professions University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumayyah","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health Indiana University\u2010Bloomington  Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2515-1748","authenticated-orcid":false,"given":"Allon N.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamainternmed.85"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.12.013"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k5301"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/1414\u2010431X202010022"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.10915"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13656"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173515"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00179.2022"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11092498"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679\u2010024\u201000583\u2010y"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.10.014"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000481825"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695\u2010024\u201007370\u20107"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.0000000512"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000006379"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02250409"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.02.039"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366\u2010018\u20100045\u2010x"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882\u2010025\u201004378\u20108"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19\u20101703"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.09.020"},{"key":"e_1_2_11_23_1","unstructured":"Regenstrief Institute Regenstrief Institute Accessed October 26 2024 https:\/\/www.regenstrief.org\/."},{"key":"e_1_2_11_24_1","volume-title":"Indiana University Office of Strategic Communications","author":"Indiana University School of Medicine"},{"key":"e_1_2_11_25_1","unstructured":"Indiana University Health Welcome to IU Health Accessed October 26 2024 https:\/\/iuhealth.org\/about\u2010our\u2010system."},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2102953"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy283"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab158"},{"key":"e_1_2_11_29_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882\u2010018\u20101188\u20107"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.14670"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16\u20102607"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.10.018"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1134644"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102023\u2010076410"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265\u2010019\u20101057\u20100"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2025.3590"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13620"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2022.101366"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010022\u201001676\u20105"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15860"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2403347"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(24)00271\u20107"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2021.08.003"}],"container-title":["Obesity Science &amp; Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/osp4.70109","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T09:15:09Z","timestamp":1766999709000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/osp4.70109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":44,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/osp4.70109"],"URL":"https:\/\/doi.org\/10.1002\/osp4.70109","archive":["Portico"],"relation":{},"ISSN":["2055-2238","2055-2238"],"issn-type":[{"value":"2055-2238","type":"print"},{"value":"2055-2238","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-06-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70109"}}