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Aims: EndoBarrier, a 60cm proximal intestinal liner, endoscopically implanted for up to one-year, reduces weight and HbA1c. As the risk of progressive chronic kidney disease (CKD) is increased by high BMI, we assessed the impact of EndoBarrier on renal function.  Methods: Between October 2014 and November 2017 we implanted EndoBarriers in 62 patients with sub-optimally controlled diabesity in our NHS service; by November 2018 all were explanted. Clinical and laboratory outcomes, including routinely performed kidney function testing by serum creatinine and MDRD eGFR, were collected in a registry  Results: In 61 patients (aged 51.4±7.2 years, 54.1% male, 57.4% europid, diabetes duration 12.0 (8.0-19.5) years, 57.4% insulin-treated, BMI 41.9±7.4 kg/m2) with implant and explant data, weight fell by 15.9±8.5 kg from 122.6±27.9 to 106.7±28.9 kg (p 133 μmol/L) prior to Endobarrier; after implantation in four of these creatinine reduced and in two normalised. The four patients with renal impairment who sustained improvement had large weight loss (19.3-34.4 kg), the patient without improvement had only 6.6 kg weight loss.  Conclusion: As well as previously documented improvements in weight, HbA1c, BP, ALT and cholesterol, EndoBarrier was associated with improvements in renal function. These observational findings warrant further investigation through prospective study of the impact of such bariatric interventions on progressive CKD.

Improvement in Renal Function in Participants in the First UK National Health Service (NHS) EndoBarrier Service for Uncontrolled Diabesity