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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2021  |  Volume : 32  |  Issue : 6  |  Page : 1813-1819
Clinical Remission of Immunoglobulin A Nephropathy after Bariatric Surgery in a Young Morbidly Obese Patient


1 Department of Nephrology, New Delhi, India
2 Institute of Medical Genetics, New Delhi, India
3 Department of Pathology, and Institute of Minimal Access, New Delhi, India
4 Institute of Minimal Access, Metabolic and Bariatric Surgery, Sir Ganga Ram Hospital, New Delhi, India
5 Department of Nephrology, Post Graduate Institute, Chandigarh, India

Correspondence Address:
Vaibhav Tiwari
Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-2442.352447

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A 23-year-old girl with morbid obesity, diabetes mellitus, hypertension, obstructive sleep apnea, and immunoglobulin A nephropathy (IgAN) attended a bariatric clinic after multiple failed attempts at weight loss. In the past, she was diagnosed with IgAN with nephrotic syndrome and raised blood pressure at the age of 11 years. Apart from optimization of blood pressure with angiotensin receptor blocker, she required steroid to maintain her remission in initial four years which was later switched to mycophenolate mofetil (MMF). She was diagnosed with diabetes at the age of 13 years; her blood sugars remained poorly controlled despite therapy with oral hypoglycemic agents and insulin. She underwent sleeve gastrectomy with no post-operative complications. During the follow-up, she showed a steady reduction in her weight, along with maintaining normal blood sugars and pressure without medications. At 18 months of follow-up, IgAN remained in remission after stopping MMF at four months after the surgery. Obesity is considered an important cofactor in the progression of IgAN. This case highlights the importance of weight reduction to halt the progression of the disease.


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