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Transplantation in the obese: separating myth from reality
1Northern General Hospital, Sheffield, UK. arif.khwaja@sth.nhs.uk
Summary
Obesity is rising in patients needing dialysis. Selected obese patients can achieve good kidney transplant outcomes, with risks comparable to other common conditions like diabetes.
Area of Science:
- Nephrology
- Transplantation
- Obesity Medicine
Background:
- Rising prevalence of obesity in patients requiring renal replacement therapy.
- Conflicting observational data on obesity and dialysis outcomes.
- Clinical reluctance to transplant obese patients due to safety concerns.
Purpose of the Study:
- To review the safety of weight loss in dialysis patients.
- To critically assess the impact of pre-transplant body mass index and sarcopenia on post-transplant outcomes.
- To compare outcomes of obese patients on dialysis versus kidney transplantation.
Main Methods:
- Literature review of existing observational and clinical data.
- Critical evaluation of studies on weight loss interventions in dialysis.
- Comparative analysis of post-transplant outcomes based on pre-transplant BMI and sarcopenia.
Main Results:
- Obesity may be linked to better outcomes in dialysis patients, but transplant centers hesitate.
- Weight loss safety in dialysis patients requires further investigation.
- Selected obese patients can achieve favorable kidney transplant outcomes.
Conclusions:
- Obesity presents risks like wound infections and delayed graft function post-transplantation.
- Carefully selected obese patients have transplant outcomes comparable to other comorbidities, such as diabetes mellitus.
- Further research is needed to optimize transplant strategies for obese dialysis patients.
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