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dc.contributor.authorPalamuthusingam, D
dc.contributor.authorSingh, A
dc.contributor.authorPalamuthusingam, P
dc.contributor.authorHawley, CM
dc.contributor.authorPascoe, EM
dc.contributor.authorJohnson, DW
dc.contributor.authorFahim, M
dc.date.accessioned2021-07-29T05:13:34Z
dc.date.available2021-07-29T05:13:34Z
dc.date.issued2021
dc.identifier.issn1871-403X
dc.identifier.doi10.1016/j.orcp.2021.06.010
dc.identifier.urihttp://hdl.handle.net/10072/406480
dc.description.abstractBackground: Obesity is a barrier to kidney transplantation for patients with kidney failure. Consequently, bariatric surgery is often considered as a bridge to transplantation, even though its risks and benefits are poorly characterised in the dialysis population. Methods: Systematic searches of observational studies indexed in Embase, MEDLINE and CENTRAL till April 2020 were performed to identify relevant studies. Risk of bias was assessed by the Newcastle Ottawa Scale and quality of evidence was summarised in accordance with GRADE methodology. Random effects meta-analyses were performed to obtain summary odds ratios for postoperative outcomes. Results: Four cohort studies involving 4196 chronic dialysis and 732,204 non-dialysis patients undergoing bariatric surgery were included. Sleeve gastrectomy (61%), and Roux-en-Y gastric bypass (29%) were the most common procedures performed. Absolute rates of adverse events were low, but the odds of postoperative mortality (0.4–0.5% vs. 0.1%; odds ratio [OR] 4.7, 95%CI 2.2–9.9), and myocardial infarction (0.0–0.5% vs. 0.1%, OR 3.4, 95% CI 2.0–5.9) were higher in dialysis compared to non-dialysis patients. Patients on dialysis also had more than 2-fold increased odds of returning to theatre and having a readmission. Rates of kidney transplant wait-listing among dialysis patients was 59%, with 28% of all patients eventually receiving a kidney transplant. Conclusion: Patients receiving chronic dialysis have substantially increased odds of postoperative mortality and myocardial infarction following bariatric surgery compared with patient who do not have kidney failure. It is uncertain whether bariatric surgery improves the likelihood of kidney transplantation, with mid- to long-term outcomes being poorly described.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherElsevier BV
dc.relation.ispartofjournalObesity Research and Clinical Practice
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchPsychology
dc.subject.fieldofresearchcode32
dc.subject.fieldofresearchcode52
dc.subject.keywordsBariatric surgery
dc.subject.keywordsEnd-stage kidney disease
dc.subject.keywordsKidney failure
dc.subject.keywordsKidney transplantation
dc.subject.keywordsPerioperative risk
dc.titlePostoperative outcomes after bariatric surgery in patients on chronic dialysis: A systematic review and meta-analysis
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationPalamuthusingam, D; Singh, A; Palamuthusingam, P; Hawley, CM; Pascoe, EM; Johnson, DW; Fahim, M, Postoperative outcomes after bariatric surgery in patients on chronic dialysis: A systematic review and meta-analysis, Obesity Research and Clinical Practice, 2021
dcterms.dateAccepted2021-06-26
dc.date.updated2021-07-26T23:10:14Z
gro.description.notepublicThis publication has been entered as an advanced online version in Griffith Research Online.
gro.hasfulltextNo Full Text
gro.griffith.authorPalamuthusingam, Dharmenaan


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