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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Obesity and bariatric intervention in patients with chronic renal disease
Maria Irene Bellini1, Filippo Paoletti2, Paul Elliot Herbert1,3
11 Renal and Transplant Directorate, Hammersmith Hospital, Imperial College NHS Trust, London, United Kingdom of Great Britain and Northern Ireland.
Abstract:
Obesity is associated with chronic metabolic conditions that directly and indirectly cause kidney parenchymal damage. A review of the literature was conducted to explore existing evidence of the relationship between obesity and chronic kidney disease as well as the role of bariatric surgery in improving access to kidney transplantation for patients with a high body mass index. The review showed no definitive evidence to support the use of a transplant eligibility cut-off parameter based solely on the body mass index. Moreover, in the pre-transplant scenario, the obesity paradox is associated with better patient survival among obese than non-obese patients, although promising results of bariatric surgery are emerging. However, until more information regarding improvement in outcomes for obese kidney transplant candidates is available, clinicians should focus on screening of the overall frailty condition of transplant candidates to ensure their eligibility and addition to the wait list.
Insights
Obesity is linked to chronic kidney disease, but body mass index alone does not determine transplant eligibility. Focus on overall patient frailty for kidney transplant candidacy.
Area of Science:
- Nephrology
- Metabolic Disorders
- Transplantation Medicine
Background:
- Obesity is a significant risk factor for chronic metabolic conditions leading to kidney damage.
- The relationship between obesity and chronic kidney disease (CKD) requires further investigation.
Purpose of the Study:
- To review existing evidence on the link between obesity and CKD.
- To explore the role of bariatric surgery in kidney transplantation for obese patients.
- To assess the validity of body mass index (BMI) as a sole criterion for transplant eligibility.
Main Methods:
- A comprehensive literature review was conducted.
- Evidence regarding obesity, CKD, and kidney transplantation was analyzed.
- The impact of bariatric surgery on transplant outcomes was examined.
Main Results:
- No definitive evidence supports using BMI as the sole determinant for kidney transplant eligibility.
- The obesity paradox suggests better survival in obese patients pre-transplant.
- Bariatric surgery shows emerging promise for improving outcomes in obese transplant candidates.
Conclusions:
- Clinicians should not rely solely on BMI for kidney transplant eligibility.
- Comprehensive frailty assessments are crucial for evaluating transplant candidates.
- Further research is needed on the long-term benefits of bariatric surgery for kidney transplant recipients.
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