{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:05:40Z","timestamp":1787828740598,"version":"build-2784847793"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"American College of Surgeons Resident Research Scholarship"},{"name":"Ontario Bariatric Network"},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Institute of Clinical and Evaluative Sciences"},{"DOI":"10.13039\/501100025092","name":"Ontario Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100025092","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100025090","name":"Ontario Ministry of Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100025090","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chronic kidney disease (CKD) is prevalent among patients with obesity, contributing to increased morbidity and mortality. Metabolic bariatric surgery (MBS) may improve kidney outcomes, but its long-term effects remain unclear. The aim of this study was to examine the association between bariatric surgery and mortality and major adverse kidney events (MAKE) in patients with a diagnosis of CKD and severe obesity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with a diagnosis of CKD (stage \u22653 and estimated glomerular filtration rate (eGFR) \u226460\u2005ml per min per 1.73\u2005m2) and BMI \u226535\u2005kg\/m2 or who underwent bariatric surgery from 2010 to 2016 in Ontario, Canada, were included. Non-surgical controls were identified from a primary care database. Multiple-linked administrative databases were used to define confounders, including age, BMI, sex, co-morbidities, socio-economic status, psychiatric history, healthcare utilization, substance misuse, and cancer screening. The primary outcomes were all-cause mortality and MAKE (a composite outcome of mortality, 50% decline in eGFR, dialysis initiation, and hospital admission for heart failure, myocardial infarction, and acute kidney injury). A multivariable Cox proportional hazards model was used for analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1538 patients (563 surgical and 975 non-surgical) followed for a median of 7.7 years, there were 285 deaths (207 (21.2%) non-surgical and 78 (13.9%) surgical). MBS was associated with 52% lower hazards of mortality (HR 0.48 (95% c.i. 0.34 to 0.67)) and 53% lower hazards of MAKE (HR 0.47 (95% c.i. 0.39 to 0.57)). Benefits were greater in females, patients aged &amp;gt;55 years, and those with a BMI &amp;gt;40\u2005kg\/m2.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>MBS was associated with reduced mortality and improved kidney outcomes in CKD patients, particularly in older individuals, females, and those with a higher BMI, highlighting its potential role in high-risk patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znaf168","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T14:52:46Z","timestamp":1756392766000},"source":"Crossref","is-referenced-by-count":1,"title":["Impact of bariatric surgery on patients with chronic kidney disease and severe obesity: multiple-linked population-based cohort study"],"prefix":"10.1093","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6257-4400","authenticated-orcid":false,"given":"Yung","family":"Lee","sequence":"first","affiliation":[{"name":"Division of General Surgery, McMaster University , Hamilton, Ontario ,","place":["Canada"]},{"name":"Harvard T.H. 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,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0543-3177","authenticated-orcid":false,"given":"Aristithes G","family":"Doumouras","sequence":"additional","affiliation":[{"name":"Division of General Surgery, McMaster University , Hamilton, Ontario ,","place":["Canada"]},{"name":"Institute of Clinical and Evaluative Sciences (IC\/ES) , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8292-2014","authenticated-orcid":false,"given":"Michael","family":"Walsh","sequence":"additional","affiliation":[{"name":"Division of Nephrology, McMaster University , Hamilton, Ontario ,","place":["Canada"]},{"name":"Population Health Research Institute (PHRI) , Hamilton, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of General 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