Renal Glomerular and Tubular Injury After Gastric Bypass in Obese Rats

Overview

Journal Nutrition

Specialty Nutritional Sciences

Date 2011 Jul 5

PMID 21723091

Citations 8

Authors

Benjamin K Canales

Leticia Reyes

Mary K Reinhard

Saeed R Khan

Carolina G Goncalves

Michael M Meguid

Affiliations

Soon will be listed here.

Abstract

Objective: Roux-en-Y gastric bypass (RYGB) surgery is the most common surgical intervention for long-term weight loss in morbidly obese patients. By decreasing obesity-associated hyperfiltration, diabetes, and hypertension, RYGB is touted to stabilize, if not prevent, progression of chronic renal disease. To test this, the renal histology of diet-induced obese rats that underwent RYGB surgery was compared with that of pair-fed and sham obese controls.

Methods: Sprague-Dawley rats, fed a high-fat, low-oxalate diet to induce gross obesity, were randomized to RYGB (n = 6), gastrointestinal-intact sham-operated obese controls (sham, n = 4), or gastrointestinal-intact sham-operated obese pair-fed controls (fed, n = 8). Daily body weight and food intake were recorded. On postoperative day 42, renal histology and immunohistochemistry were examined. Renal pathology was assessed by a categorical glomerular lesion score and a quantitative glomerular/tubular scoring system by experienced veterinary pathologists. Osteopontin and ED-1 (monocyte/macrophage cell) stainings were estimated by the percentage of stained area and the number of counted cells/high-power field, respectively.

Results: Compared with sham and fed controls, RYGB rats had significant decreases in body weight (P < 0.001), more glomerular lesions (P = 0.02), and received higher glomerular and tubular lesion scores (P < 0.01). RYGB rodents had significantly stronger staining for osteopontin within the inner medullary region (P < 0.005) and ED-1 within the outer medullary region (P < 0.02) compared with sham and fed controls.

Conclusion: In this diet-induced obese rat model, RYGB is associated with chronic glomerulosclerosis and tubulointerstitial nephritis, confirmed by histology and immunohistochemistry. Prospective studies to better define the injurious mechanisms in this model are underway.

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References

Maalouf N, Tondapu P, Guth E, Livingston E, Sakhaee K . Hypocitraturia and hyperoxaluria after Roux-en-Y gastric bypass surgery. J Urol. 2010; 183(3):1026-30. PMC: 3293469. DOI: 10.1016/j.juro.2009.11.022. View

Reinhard M, Hottendorf G, Powell E . Differences in the sensitivity of Fischer and Sprague-Dawley rats to aminoglycoside nephrotoxicity. Toxicol Pathol. 1991; 19(1):66-71. DOI: 10.1177/019262339101900108. View

Guijarro A, Osei-Hyiaman D, Harvey-White J, Kunos G, Suzuki S, Nadtochiy S . Sustained weight loss after Roux-en-Y gastric bypass is characterized by down regulation of endocannabinoids and mitochondrial function. Ann Surg. 2008; 247(5):779-90. PMC: 2671862. DOI: 10.1097/SLA.0b013e318166fd5f. View

Sjostrom L, Narbro K, Sjostrom C, Karason K, Larsson B, Wedel H . Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007; 357(8):741-52. DOI: 10.1056/NEJMoa066254. View

Requarth J, Burchard K, Colacchio T, Stukel T, Mott L, Greenberg E . Long-term morbidity following jejunoileal bypass. The continuing potential need for surgical reversal. Arch Surg. 1995; 130(3):318-25. DOI: 10.1001/archsurg.1995.01430030088018. View

Patel B, Passman C, Fernandez A, Asplin J, Coe F, Kim S . Prevalence of hyperoxaluria after bariatric surgery. J Urol. 2008; 181(1):161-6. PMC: 2637794. DOI: 10.1016/j.juro.2008.09.028. View

Buchwald H, Avidor Y, Braunwald E, Jensen M, Pories W, Fahrbach K . Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004; 292(14):1724-37. DOI: 10.1001/jama.292.14.1724. View

Nelson W, Houghton S, Milliner D, Lieske J, Sarr M . Enteric hyperoxaluria, nephrolithiasis, and oxalate nephropathy: potentially serious and unappreciated complications of Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2006; 1(5):481-5. DOI: 10.1016/j.soard.2005.07.002. View

Navarro-Diaz M, Serra A, Romero R, Bonet J, Bayes B, Homs M . Effect of drastic weight loss after bariatric surgery on renal parameters in extremely obese patients: long-term follow-up. J Am Soc Nephrol. 2006; 17(12 Suppl 3):S213-7. DOI: 10.1681/ASN.2006080917. View

10.

Matlaga B, Shore A, Magnuson T, Clark J, Johns R, Makary M . Effect of gastric bypass surgery on kidney stone disease. J Urol. 2009; 181(6):2573-7. DOI: 10.1016/j.juro.2009.02.029. View

11.

Blackburn G . The 2008 Edward E. Mason Founders lecture: interdisciplinary teams in the development of "best practice" obesity surgery. Surg Obes Relat Dis. 2008; 4(5):679-84. DOI: 10.1016/j.soard.2008.06.002. View

12.

Saliba J, Kasim N, Tamboli R, Isbell J, Marks P, Feurer I . Roux-en-Y gastric bypass reverses renal glomerular but not tubular abnormalities in excessively obese diabetics. Surgery. 2009; 147(2):282-7. PMC: 2813906. DOI: 10.1016/j.surg.2009.09.017. View

13.

Chagnac A, Weinstein T, Korzets A, Ramadan E, Hirsch J, Gafter U . Glomerular hemodynamics in severe obesity. Am J Physiol Renal Physiol. 2000; 278(5):F817-22. DOI: 10.1152/ajprenal.2000.278.5.F817. View

14.

DRENICK E, Stanley T, Border W, Zawada E, Dornfeld L, Upham T . Renal damage with intestinal bypass. Ann Intern Med. 1978; 89(5 Pt 1):594-9. DOI: 10.7326/0003-4819-89-5-594. View

15.

Xu Y, Ohinata K, Meguid M, Marx W, Tada T, Chen C . Gastric bypass model in the obese rat to study metabolic mechanisms of weight loss. J Surg Res. 2002; 107(1):56-63. DOI: 10.1006/jsre.2002.6508. View

16.

Park A, Storm D, Fulmer B, Still C, Wood G, Hartle 2nd J . A prospective study of risk factors for nephrolithiasis after Roux-en-Y gastric bypass surgery. J Urol. 2009; 182(5):2334-9. DOI: 10.1016/j.juro.2009.07.044. View

17.

Whitson J, Stackhouse G, Stoller M . Hyperoxaluria after modern bariatric surgery: case series and literature review. Int Urol Nephrol. 2009; 42(2):369-74. PMC: 2886902. DOI: 10.1007/s11255-009-9602-5. View

18.

Quinn R . Comparing rat's to human's age: how old is my rat in people years?. Nutrition. 2005; 21(6):775-7. DOI: 10.1016/j.nut.2005.04.002. View

19.

Meguid M, Ramos E, Suzuki S, Xu Y, George Z, Das U . A surgical rat model of human Roux-en-Y gastric bypass. J Gastrointest Surg. 2004; 8(5):621-30. DOI: 10.1016/j.gassur.2004.02.003. View

20.

Khan S, Shevock P, HACKETT R . Urinary enzymes and calcium oxalate urolithiasis. J Urol. 1989; 142(3):846-9. DOI: 10.1016/s0022-5347(17)38928-0. View