From a recent Diabetes Care article:
Our data suggest robust benefits for renal outcomes, heart failure, and CV [cardiovascular] mortality after GBP [gastric bypass] in individuals with obesity and T2DM. These results suggest that marked weight loss yields important benefits, particularly on the cardiorenal axis (including slowing progression to end-stage renal disease), whatever the baseline renal function status.
Because of the risk of surgery, I’d make sure first that diet modification was seriously tried and failed.
Steve Parker, M.D.