How Gastric Sleeve Bariatric Surgery Can Lower Your Long-Term Risk of Chronic Kidney Disease

By Northwest Weight & Wellness Center – Everett, Washington

Based on the article: https://www.medscape.com/viewarticle/bariatric-surgery-may-lower-long-term-ckd-risk-2025a1000ob8?form=fpf 

Introduction

At Northwest Weight & Wellness Center in Everett, Washington, we are committed to helping individuals transform their health through safe and effective bariatric surgery. A groundbreaking new study from Denmark, published in BMC Nephrology and reported by Medscape, shows that bariatric surgery—including both gastric sleeve surgery and Roux-en-Y gastric bypass—can significantly reduce long-term risk of chronic kidney disease (CKD) and kidney failure with replacement therapy (KFRT), while presenting only minimal short-term kidney-related risks.

In this article, we break down the findings of this large study and explain how gastric sleeve surgery (SG) may protect kidney function while helping you achieve life-changing weight loss.

Understanding the Study: Bariatric Surgery and Long-Term Kidney Outcomes

Study Design and Population

• Danish researchers analyzed national registry data on adult patients who had either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2006 and 2018.
• The surgical group included 18,827 patients (17,200 RYGB; 1,627 SG) matched 1:5 by age and sex to 94,135 people with overweight or obesity who did not undergo surgery.
• They were also compared to a general population cohort matched by age and sex.
• The median age was 41 years, 76% were women, and follow-up averaged 8.1 years. Baseline estimated glomerular filtration rate (eGFR) and A1c levels were similar across groups.
  

Kidney Outcomes Measured

Researchers tracked the 10-year risk of:

1. Acute Kidney Injury (AKI) – within 1 year after surgery
2. Nephrolithiasis (kidney stones) – over 10 years
3. Chronic Kidney Disease (CKD G3–G5) – over 10 years
4. Kidney Failure with Replacement Therapy (KFRT) – dialysis or transplant, over 10 years
   

Key Findings: Risks and Benefits

• Within 1 year, bariatric surgery patients had a 2.7% risk of AKI, with a hazard ratio (HR) of 1.63 compared to non-surgical controls.
• Over 10 years, the risk of nephrolithiasis was 3.5%, with an HR of 1.73.
• The 10-year risk of CKD (G3–G5) was only 0.4%, with an HR of 0.41—a 59% lower risk compared to controls.
• The 10-year risk of KFRT was 0.2%, with an HR of 0.63, reflecting a 37% lower risk compared to controls.

When broken down by procedure type:

• AKI risk was 2.7% after RYGB and 2.4% after SG
• Nephrolithiasis risk was 3.6% after RYGB versus just 1.2% after SG
• KFRT risk was 0.2% after RYGB and 1.6% after SG

This shows that gastric sleeve surgery (SG) carries lower short-term kidney stone and AKI risks, while still providing powerful long-term protection against CKD.

Why Does Gastric Sleeve Surgery Help Protect Against CKD?

The Link Between Obesity, Diabetes, and Kidney Disease

Obesity is a major driver of chronic kidney disease, especially when combined with type 2 diabetes and high blood pressure. These conditions place stress on the kidneys, accelerating damage over time.

Bariatric surgery—especially gastric sleeve surgery—helps reverse these risk factors by promoting:

• Better blood sugar control
• Lower blood pressure
• Reduced inflammation
• Improved cholesterol and triglyceride levels

These metabolic improvements protect your kidneys and reduce your risk of CKD progression.

RYGB vs Sleeve Gastrectomy

• RYGB can raise the risk of kidney stones due to changes in fat absorption and oxalate levels.
• Sleeve gastrectomy has a lower risk of kidney stones (1.2% vs 3.6% at 10 years in this study).
• Both surgeries offer strong long-term kidney protection, but SG may be more kidney-friendly overall.

What This Means for Patients Considering Gastric Sleeve Surgery

1. Powerful Long-Term Kidney Protection
   Gastric sleeve surgery significantly lowers the long-term risk of chronic kidney disease (CKD stages G3–G5) and the need for dialysis or transplant (KFRT).
2. Manageable Short-Term Risks
   While there is a small increase in the risk of AKI or kidney stones, these are lower with SG than with RYGB—and are greatly outweighed by the long-term health benefits.
3. Sleeve Gastrectomy May Be Safer for Kidney Health
   For patients concerned about kidney complications, SG is a strong option with excellent weight-loss results and lower risk of nephrolithiasis.
4. Comprehensive, Team-Based Care
   At Northwest Weight & Wellness Center, we use a multidisciplinary approach. Our surgeons, nephrologists, dietitians, and primary care providers work together to minimize risks and support your recovery.
5. Lifelong Healthy Habits Are Essential
   After surgery, we guide patients in:
   • Staying hydrated to prevent stones
   • Monitoring calcium and oxalate intake
   • Using calcium citrate if needed
   • Regular kidney function labs (eGFR, A1c, blood pressure, etc.)

Supporting Evidence from Other Research

• Chang et al. (2016): Bariatric surgery improved kidney function in severely obese patients.
• Friedman et al. (2018): Weight-loss surgery reduced CKD risk over 7 years.
• Kassam et al. (2020): Bariatric surgery reduced kidney function decline in patients with eGFR <90.
• Kukla et al. (2024): Bariatric surgery is safe and effective even in patients with advanced CKD.

These studies support the new Danish data showing gastric sleeve and other forms of metabolic surgery protect long-term kidney function.

Conclusion

At Northwest Weight & Wellness Center in Everett, our goal is to help you achieve lasting weight loss and long-term health. The latest evidence confirms that gastric sleeve surgery not only drives substantial weight loss but also provides significant protection against chronic kidney disease and kidney failure.

While short-term risks like acute kidney injury and nephrolithiasis can occur, these are rare, manageable, and far outweighed by the long-term benefits.

If you’re ready to reclaim your health, reduce your risk of chronic kidney disease, and achieve lasting weight loss, contact Northwest Weight & Wellness Center today. Our expert team is here to support you every step of the way.