Reply
Michelle J. Semins, Brian R. Matlaga, Andrew D. Shore, Kimberly Steele, Thomas Magnuson, Roger Johns, Martin A. Makary
Urology
October 2009 (Vol. 74, Issue 4, Page 750) Full Text |
Full-Text PDF (88 KB)
Objectives
To evaluate the likelihood of being diagnosed with, or treated for, an upper urinary tract calculus after gastric banding. Bariatric surgical procedures are being increasingly utilized in the treatment of patients with morbid obesity. Certain malabsorptive bariatric procedures have been associated with an increased risk for kidney stone formation. However, the kidney stone risk of gastric banding, a restrictive bariatric procedure, is unknown.
Methods
We identified 201 patients who underwent gastric banding and a control group of 201 obese patients who did not have bariatric surgery in a national private insurance claims database within a 5-year period from 2002-2006. All patients had at least 2 years of continuous claims data follow-up. Our 2 primary outcomes were the diagnosis and the surgical treatment of a urinary calculus.
Results
After gastric banding, the diagnosis of an upper urinary tract calculus occurred in 3 subjects (1.49%), as compared with 12 subjects (5.97%) in the comparison cohort (P = .0179). One subject in each cohort (0.50%) underwent a surgical procedure for the treatment of an upper urinary tract (P = 1.0000).
Conclusions
Gastric banding is not associated with an increased risk for kidney stone disease or kidney stone surgery in the postoperative period. Additional long-term studies are required to confirm these findings.
aDepartment of Urology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
bDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
cDepartment of Anesthesiology, The Johns Hopkins University School of Medicine, and the Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland
Reprint requests: Brian R. Matlaga, M.D., M.P.H., James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, 600 North Wolfe St, Baltimore, MD 21287
This study was funded by the Hariri Family Foundation and Mr and Mrs Chad and Nissa Richinson. This publication was made possible by Grant Number T32DK07552 from NIH-NIDDK.
The dataset used in this current study was originally created for a different research project on patterns of obesity care within selected Blue Cross/Blue Shield (BCBS) plans. The previous research project (but not the current study) was funded by unrestricted research grants from Ethicon Endo-Surgery, Inc. (a Johnson & Johnson company); Pfizer, Inc.; and GlaxoSmithKline. The contents of the study are solely the responsibility of the authors and do not necessarily represent the official views of the NIH-NIDDK.
ABSTRACT