I am obese with CKD and diabetes. Will metabolic surgery help?

Question

Hi doctor,

I have been struggling with obesity for many years and have tried multiple diets and medications without long-term success. My weight has been affecting my quality of life and worsening my other health issues, especially since I also have chronic kidney failure and am currently on dialysis.

I have been reading about metabolic surgery and how it can help with weight loss and improve conditions like diabetes and hypertension, which I also have. I am seriously considering it, but I am concerned about how safe it is for someone with kidney failure.

Can I still be a candidate for metabolic surgery even though I am on dialysis? Will the surgery have any impact on my kidney function or dialysis routine? I am also curious about how the recovery process might differ for someone with my condition. Are there any special precautions I need to be aware of?

Please help.

Answer 1

Hi

Welcome to icliniq.com.

I understand your concern.

Regarding your question about having metabolic (bariatric) surgery while on dialysis. The answer is yes, you can be a candidate, but it needs special care and a team of doctors to evaluate you properly, including a kidney doctor (nephrologist), surgeon, and dietitian.

The benefits include:

It helps with long-term weight loss.
It can improve diabetes and blood pressure.
It may improve your chances of getting a kidney transplant.
It can improve the quality of life.

Dialysis patients have more risks with surgery, like:

Fluid and salt imbalances.
Infections.
Slower wound healing.
Nutritional deficiencies (you will need lifelong supplements).

Regarding your query on recovery, yes, you may stay in the hospital longer. Your dialysis schedule might change during recovery. Your diet after surgery will need to be specially planned for both the kidney and the surgical needs. You will need regular blood tests and follow-up care.

The precautions that you must take include:

Choose a bariatric center with experience in kidney or dialysis patients.
Make sure your nephrologist and surgeon work together.
Follow a strict infection control routine. Take special supplements for vitamins and minerals. Have a dietitian help manage your post-surgery meals.

I hope this answers your query.

Kindly follow up if you have more doubts.

Thank you.