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Bariatric surgery is superior to intensive medical therapy for weight loss and improved metabolic function in appropriately selected patients. In this trial, researchers looked specifically at the effect of bariatric surgery on proteinuria in 100 obese patients with type 2 diabetes and microalbuminuria (median urinary albumin-creatinine ratio [uACR], 73 mg/g). At baseline, mean age was 51, mean body-mass index was 33 kg/m2, and median serum creatinine was 0.8 mg/dL. Patients were randomized to receive either laparoscopic roux-en-Y gastric bypass or best medical therapy.
At 24 months, microalbuminuria had resolved (uACR levels, <30 mg/g) in 84% of the gastric bypass group versus 56% of the medical therapy group. Mean weight loss among patient…