A history of bariatric surgery is associated with a shorter length of stay for patients undergoing renal transplant

Background: Obesity is increasingly linked to chronic kidney disease, and most patients with end-stage renal disease would benefit from kidney transplantation. Bariatric surgery is the most effective treatment for obesity and possibly improves postrenal transplant outcomes in patients with obesity. Objective: To determine if a history of bariatric surgery is predictive of length of stay (LOS) after kidney transplantation. Setting: National inpatient stays in the United States. Methods: The National Inpatient Sample (NIS) from 2016 to 2021 was combined, and patients undergoing kidney transplantation were identified with relevant health factors recorded. Cohorts stratified by prior bariatric surgery were identified. Characteristics and outcomes were compared with Welsh t-tests and chi-squared tests. A multivariable linear regression model was created against LOS. Five groups by LOS time were formed and rates of mortality, organ rejection or failure, sepsis, adverse reaction to immunosuppressant therapy, and urinary tract infection (UTI) compared. Results: Twenty-four thousand seven hundred eighty-seven patients were identified with admission for kidney transplantation and 654 (2.6%) had undergone previous bariatric surgery. Patients with a history of bariatric surgery were more frequently female, had obesity, and had diabetes, anticoagulant therapy, sleep apnea, and anxiety or depression. The linear regression modeling showed that patients with history of bariatric surgery had decreased LOS (5.6 versus 6.4 days, P < .001). Patients with increased LOS were associated with greater morbidity (P < .05). Conclusion: Previous bariatric surgery is associated with decreased LOS in patients undergoing kidney transplantation. Care teams should be aware of predictors of LOS, as longer LOS is associated with increased postoperative complications and hospital costs.