Obesity Clinical Trial
Official title:
Effect of Weight Loss Induced by a Bypass Surgery on Renal Salt Excretion, Renal Hemodynamic and on Neurohormonal Responses During an Induced Orthostatic Stress in Obese Patients
The sympathetic nervous (SNS) and the renin angiotensin aldosterone system (RAS) have a
direct impact on renal hemodynamic, hormonal secretion and vasoactive peptide. Many
mechanisms including the SNS, RAS and renal sodium handling could explain the pathogenesis of
hypertension in obese patients. Lifestyle changes and bariatric surgery induce weight loss,
which is associated with blood pressure lowering in obese patients. A diminution in the renal
sympathetic stimulation and RAS activation could explain this effect.
The AIM of this study is to show that weight loss induced by bypass surgery in obese patients
affects renal salt excretion under " low body negative pressure (LBNP)" conditions .
Secondary objectives are to investigate the impact of weight loss on renal hemodynamic
(glomerular filtration rate (GFR), renal plasma flow) and neurohormonal responses under " low
body negative pressure conditions ". We will also analyse renal blood oxygenation with Blood
Oxygenation dependant IRM (BOLD-IRM) technique before and after weight loss.
The population of this study will consist in two groups including 36 patients. The first one
will include 24 obese patients that are going to undergo a bariatric surgery. The second one
will include 12 obese patients without any weight loss associated surgery.
Both group will undergo 3 investigation days. Each patient will have to undergo a screening
visit that will provide dietary advice to ensure a standardized salt intake (120-180
mmol/day) for the duration of the study. The first investigation will define baseline, the
second and third day of investigation will take place after 3 month and 12 month after
bariatric surgery for surgical patients or after baseline for patients without surgery. One
to two weeks before phase 1 and 3 patients will perform a BOLD-MRI. The surgery group will
undergo bariatric surgery between the first investigation phase (baseline) and the second. An
ambulatory blood pressure and 24-hour urine collection will precede each investigation day.
An investigation day consists in renal hemodynamics, neurohormonal and natriuretic response
measurements before, during and after 60 min of LBNP at -30mbar . The duration of the study
per subject is going to take 12 months.
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