Roux-en-Y gastric bypass surgery almost doubles an individual’s risk of developing kidney stones, researchers at the Johns Hopkins University School of Medicine have reported.
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In a paper published in the Journal of Urology, Dr. Brian Matlaga of the James Buchanan Brady Urological Institute and his colleagues reported that 7.65% of patients who underwent the surgery developed kidney stones, in comparison to 4.63% of a group of obese control patients who did not undergo the surgery.
Kidney stones most often are concretions of a compound called calcium oxalate. Normally, dietary calcium binds to oxalate in the digestive tract, preventing its absorption. In patients who undergo Roux-En-Y surgery, a portion of the small intestine is removed, limiting the patient’s ability to absorb fat, which breaks down into fatty acids. These fatty acids then combine with calcium to form a soap-like substance, preventing calcium from binding to oxalate in the GI tract.
Dr. Matlaga noted that patients who undergo this type of surgery are put on a strict regimen of vitamin and mineral supplements, including calcium. “The question is, should certain patients receive more supplements than others? I think that’s a reasonable thing to investigate.”
When asked if the problem was due to patient non-compliance, he answered, “That’s certainly one thing to consider.” He noted that even patients who have not had the surgery vary widely both in their ability to absorb oxalate from the GI tract and in the level of endogenous production of oxalate by the liver. “Although certainly compliance may be one driving force, other forces could be certain unique features of patients.”
Dr. Matlaga cautioned that his group’s results should not be construed as an indication for morbidly obese patients to avoid bariatric surgery. “If you were going to rank in order things you would not want to have, most patients would put things like diabetes, heart disease, sleep apnea, pregnancy complications, all these things are going to rank higher than kidney stones.
“The benefit of gastric bypass surgery is that these patients have reduced mortality, they have increased rate of resolution of diabetes, of heart disease, of high blood pressure. Gastric bypass surgery is fixing a lot of these serious health problems. Perhaps in some patients an increased risk for kidney stone disorder may be one of those tradeoffs.
“Calcium supplementation, increased fluid intake, other dietary changes can try to control that risk to some extent.”
When asked if morbidly obese patients would be better off getting the lap band surgery, which does not inhibit absorption of nutrients, he replied, “I think certainly it’s something that someone who looks at all these data would see is a prime area for investigation.
“With the rate of rise of obesity and increasing utilization of bariatric surgery, that’s probably an issue that’s of interest to many people and it’s not going away any time soon.”
Comments
I wouldn't trust anything that comes out of Hopkins. Google "Adventures in Cardiology"
To Dan:
I've glanced at the page, and it looks interesting. I'll have a closer look when I have more time. Thanks for reading and commenting.
Here is some interesting information on the issue of traditional, versus endoscopic, cardiac bypass surgery: Safety of Minimally Invasive Bypass Technique Questioned: newsinferno dot com/archives/8548#more-8548
It could be possible but having lots of benefits for those whose BMI is greater than 40. Such types of information you will collect from one place...
www(dot)freelapbandsurgery(dot)com
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