Impact of Roux-en-Y gastric bypass in metabolic indicators of kidney function in women with obesity and type 2 diabetes mellitus.

• Grant number: 22/15871-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): March 01, 2023
• Effective date (End): February 29, 2024
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Raquel Susana Matos de Miranda Torrinhas
• Grantee: Lucas Santander
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Kidney disease is a worldwide public health problem which affects productive individuals and promotes considerable worsening quality of life. Obesity is one of the main causes of kidney disease, particularly due to increased predisposition to diabetic nephropathy, hypertensive nephrosclerosis, focal and segmental glomerulosclerosis. The relationship between obesity and kidney disease is explained by hemodynamic, structural, histological, metabolic and biochemical changes in the kidney. The growing trend of overweight already affects more than half of Brazilian population and increases kidney disease predisposition.Roux-en-Y gastric bypass (RYGB) is considered an effective intervention for obesity treatment, and recent studies indicate that this surgical technique can also promote significantly impacts in renal function, and its efficiency can be superior than best clinical treatments currently available. RYGB combines nutrient restriction and alters nutrient absorption, producing several systemic and gastrointestinal metabolic effects. Investigation of these changes can improve our understanding of surgery mechanisms of action, enabling future clinical interventions towards new therapeutic targets.By reflecting biological system responses to intern and environmental changes, molecules produced or modified by metabolism (metabolites) act as potential biomarkers to identify health or disease conditions. Kidney disease development is widely associated with changes in specific metabolites, and these molecules seems to have a promising potential to reveal early stages alterations, overcoming sensitivity of classic indicators of kidney function, whose alterations are detectable only after stablishiment of irreversible changes.In this sense, the present study is willing to investigate the effect of RYGB on kidney function, considering classic biomarkers of creatinine and microalbuminuria, and metabolite changes considered as potential biomarkers linked to diabetic nephropathy and chronic kidney disease.This is a paired metabolomic study, conducted with women with obesity-related type 2 diabetes, underwent RYGB. Patients will be divided in two groups, according to the presence of established renal alterations. Data from plasma and urine samples analyzed by liquid and at pre-operative and 3-month postoperative period of RYGB. Metabolite correlations to biochemical and urinary markers will also be evaluated.