Chronic inflammatory complications of diabetes such as kidney disease reduce quality of life and life-expectancy. Gastric bypass (GB) and vertical sleeve gastrectomy (VSG) are gut operations known as “metabolic surgery” given their effectiveness as treatments for obesity and diabetes. These surgeries represent intensive treatments for diabetes and are associated with evidence of reduced diabetic kidney damage in both experimental animal models and human studies.
High levels of a protein that can be measured in blood (tumour necrosis factor receptor 1 (TNFR1)) can predict which patients run a higher risk of developing progressive kidney disease. Changes in the levels of this protein after intensive treatments may also be of value in predicting reductions in long-term risk.
I aim to;
1) Measure circulating levels of TNFR1 in samples from diabetic patients taken before and 1 year after metabolic surgery. 2) Relate any changes to the degree of improvement in the levels of markers of kidney injury and inflammation measurable in urine.
