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● An initial, reversible eGFR reduction of 5–8 mL/min/1.73 m² may occur within the first few weeks due to decreased hyperfiltration
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Future guidelines would benefit from integrating multidimensional tools such as the Edmonton Obesity Staging System (EOSS) and requiring targeted medical therapy trials prior to surgical referral—ensuring that bariatric surgery is offered to those most likely to benefit, and that treatment decisions align with the evolving landscape of obesity care
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