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Comment & Response
November 18, 2020

The Role of Bariatric Surgery in Prevention of Kidney Disease Progression in Moderately Obese Patients With Type 2 Diabetes—Reply

Author Affiliations
  • 1The Center for Obesity and Diabetes, Oswaldo Cruz German Hospital, São Paulo, Brazil
  • 2Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
  • 3Department of Health Sciences, University of Leicester College of Medicine, Leicester, England
  • 4Diabetes Complications Research Center, UCD Conway Institute, University College Dublin School of Medicine, Dublin, Ireland
JAMA Surg. 2021;156(2):206-207. doi:10.1001/jamasurg.2020.5192

In Reply The Microvascular Outcomes After Metabolic Surgery (MOMS) study demonstrated that Roux-en-Y gastric bypass (RYGB) can be used to place early stages of chronic kidney disease (CKD) in patients with type 2 diabetes into remission.1 Patoulias et al suggested that remission of albuminuria was enhanced by RYGB because more of these patients at baseline received glucagon-like peptide-1 receptor agonist (GLP-1RA). A subanalysis of patients undergoing RYGB according to presurgery treatment with a GLP-1RA found that the treatment did not predict albuminuria response. It should be remembered that GLP-1RA were stopped immediately after RYGB, although metformin, angiotensin-converting enzyme inhibitors, and statins were continued where possible.

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