Clinical Nutrition Research

  • 제13권4호
  • /
  • Pages.238-243
  • /
  • 2024
  • /
  • 2287-3732(pISSN)
  • /
  • 2287-3740(eISSN)
한국임상영양학회 (The Korean Society of Clinical Nutrition)
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Nutritional Management for Chronic Kidney Disease Undergoing Bariatric Surgery: A Case Report

  • Yunjung Choi (Department of Food Service and Nutrition Care, Seoul National University Hospital) ;
  • Jiyoung Song (Department of Food Service and Nutrition Care, Seoul National University Hospital) ;
  • Jeong Hyun Lim (Department of Food Service and Nutrition Care, Seoul National University Hospital) ;
  • Dal Lae Ju (Department of Food Service and Nutrition Care, Seoul National University Hospital)
  • 투고 : 2024.10.03
  • 심사 : 2024.10.21
  • 발행 : 2024.10.30
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초록

Nutrition support is an essential aspect of treatment after bariatric surgery (BS). A high-protein diet with an intake of up to 1.5 g/kg of ideal body weight (IBW) per day is recommended to minimize loss of lean body mass after BS. However, protein intake recommendations may need to be adjusted for patients with compromised renal function, necessitating an individualized approach tailored to each patient's clinical status. This case report aimed to demonstrate nutritional evaluation, education, and counseling for a male patient with chronic kidney disease (CKD) who underwent BS one year after surgery. Following BS, the patient adhered to the standard Seoul National University Hospital BS diet protocol. Considering his postoperative renal function, protein requirement was set at 1.0 g/kg of IBW. A total of 10 individualized nutritional counseling sessions were conducted according to renal function and complications. One year after BS, he successfully lost weight with % excess weight loss of 93%, maintained CKD stage 3, reduced prescription of oral hypoglycemic agent, improved glycated hemoglobin levels, and improved eating habits significantly. Thus, individualized nutrition intervention is important for supporting patients with CKD to reach their goal weight after BS, improve nutritional status, and prevent postoperative complications.

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참고문헌

  1. Docherty NG, le Roux CW. Bariatric surgery for the treatment of chronic kidney disease in obesity and type 2 diabetes mellitus. Nat Rev Nephrol 2020;16:709-20.
  2. Sherf Dagan S, Goldenshluger A, Globus I, Schweiger C, Kessler Y, et al. Nutritional recommendations for adult bariatric surgery patients: clinical practice. Adv Nutr 2017;8:382-94.
  3. Guideline Committee for Metabolic and Bariatric Surgery, Korean Society for Metabolic and Bariatric Surgery. Korean Society of Obesity and Metabolic Surgery guidelines for bariatric surgery. J Metab Bariatr Surg 2018;7:1-21.
  4. Ben-Porat T, Weiss-Sadan A, Rottenstreich A, Sherf-Dagan S, Schweiger C, et al. Nutritional management for chronic kidney disease patients who undergo bariatric surgery: a narrative review. Adv Nutr 2019;10:122-32.
  5. Kukla A, Kudva YC, Navratil P, Sahi SS, Benzo RP, et al. Management of patients with kidney disease undergoing bariatric surgery: a multidisciplinary approach. Mayo Clin Proc 2024;99:445-58.
  6. Majorowicz RR, Attia A, Bamlet HM, Clegg DJ, Diwan T, et al. Nutritional considerations for patients with renal failure undergoing sleeve gastrectomy. J Ren Nutr 2024;34:76-86.
  7. Li M, Liu Y, Zeng N, Liu J, Bian S, et al. Alterations in the serum urate concentrations after bariatric surgery: a short-term prospective observational study. Obes Surg 2021;31:1688-95.
  8. Chang AR, Chen Y, Still C, Wood GC, Kirchner HL, et al. Bariatric surgery is associated with improvement in kidney outcomes. Kidney Int 2016;90:164-71.
  9. Coleman KJ, Shu YH, Fischer H, Johnson E, Yoon TK, et al. Bariatric surgery and risk of death in persons with chronic kidney disease. Ann Surg 2022;276:e784-91.
  10. Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures - 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Surg Obes Relat Dis 2020;16:175-247.
  11. Peterson LA, Cheskin LJ, Furtado M, Papas K, Schweitzer MA, et al. Malnutrition in bariatric surgery candidates: multiple micronutrient deficiencies prior to surgery. Obes Surg 2016;26:833-8.
  12. Ben-Porat T, Weiss R, Sherf-Dagan S, Nabulsi N, Maayani A, et al. Nutritional deficiencies in patients with severe obesity before bariatric surgery: what should be the focus during the preoperative assessment? J Acad Nutr Diet 2020;120:874-84.
  13. Gagner M, Deitel M, Erickson AL, Crosby RD. Survey on laparoscopic sleeve gastrectomy (LSG) at the fourth international consensus summit on sleeve gastrectomy. Obes Surg 2013;23:2013-7.
  14. Endevelt R, Ben-Assuli O, Klain E, Zelber-Sagi S. The role of dietician follow-up in the success of bariatric surgery. Surg Obes Relat Dis 2013;9:963-8.