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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Obesity Management in Kidney Transplant Candidates: Current Paradigms and Gaps in Knowledge
Advances in chronic kidney disease, v 28(6), pp 528-541
Nov 2021
PMID: 35367021
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
In this review, we discuss the increasing prevalence of obesity among people with chronic and end-stage kidney disease (ESKD) and implications for kidney transplant (KT) candidate selection and management. Although people with obesity and ESKD receive survival and quality-of-life benefits from KT, most KT programs maintain strict body mass index (BMI) cutoffs to determine transplant eligibility. However, BMI does not distinguish between visceral adiposity, which confers higher cardiovascular risks and risks of perioperative and adverse posttransplant outcomes, and muscle mass, which is protective in ESKD. Furthermore, requirements for patients with obesity to lose weight before KT should be balanced with the findings of numerous studies that show weight loss is a risk factor for death among patients with ESKD, independent of starting BMI. Data suggest that KT is associated with survival benefits relative to remaining on dialysis for candidates with obesity although recipients without obesity have higher delayed graft function rates and longer transplant hospitalization durations. Research is needed to determine the optimal body composition metrics for KT candidacy assessments and risk stratification. In addition, ESKD-specific obesity management guidelines are needed that will address the neurologic, behavioral, socioeconomic, and physical underpinnings of this increasingly common disease.
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Details
- Title
- Obesity Management in Kidney Transplant Candidates: Current Paradigms and Gaps in Knowledge
- Creators
- Joanna H. Lee - Drexel UniversityElysia O. McDonald - Drexel UniversityMeera N. Harhay - Drexel University
- Publication Details
- Advances in chronic kidney disease, v 28(6), pp 528-541
- Publisher
- Elsevier
- Grant note
- K23DK105207; RO1DK124388 / NIH
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000807837400004
- Scopus ID
- 2-s2.0-85127164554
- Other Identifier
- 991019335610404721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Urology & Nephrology