Journal article
Patient and Health Care Professional Perspectives on Addressing Obesity in ESKD
American journal of kidney diseases, v 82(4), pp 419-428
01 Oct 2023
PMID: 37086964
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Obesity is common among patients with end-stage kidney disease (ESKD) and is a pervasive barrier to kidney transplantation. Patient perspectives about barriers to weight loss and patient and health care professionals' viewpoints about optimal obesity management in ESKD are needed.
Qualitative study using a descriptive phenomenological approach to understand ESKD patients' lived experiences with obesity and weight loss and patients' and health professionals' perceptions about optimal obesity care for ESKD patients.
Between October 2020 and December 2021, we conducted 90-minute semi-structured interviews with 40 ESKD patients with obesity (body mass index [BMI] ≥30 kg/m) and 60-minute interviews with 20 ESKD health care professionals.
Deductive and inductive thematic analysis of interviews.
Among patients with ESKD, the median (interquartile rage [IQR]) age was 55 (46-63) years, median BMI was 39.5 (35.3, 41.6) kg/m2, median dialysis vintage was 5 (3,8) years, 58% were female, and 46% were non-Hispanic white. Among health care professionals, 50% were renal dietitians, 20% were nephrologists, and the remainder were transplant professionals (surgeons, nephrologists, and dietitians). ESKD patients described unique weight loss challenges, including: 1) conflicting tenets of "kidney-friendly" vs popular diets, 2) fatigue due to dialysis that affects dietary choices, 3) perceived pressure and unrealistic expectations from health professionals to lose weight for kidney transplantation. Professionals and patients described a lack of transparent and honest communication about obesity and unclear roles and responsibilities for obesity counseling.
Lack of caregiver perspectives and potential lack of transferability to overall dialysis population given overrepresentation of patients with severe obesity and previous weight loss surgery.
Obesity interventions for ESKD patients should be tailored to meet the unique challenges reported by patients with ESKD. Clarifying ESKD health professionals' roles and responsibilities for obesity care would help to ensure that patients have consistent and effective support to manage obesity.
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Details
- Title
- Patient and Health Care Professional Perspectives on Addressing Obesity in ESKD
- Creators
- Meera Nair Harhay - Drexel UniversityAnn C Klassen - Drexel UniversityBengucan Gunen - Drexel UniversitySneha Hingorany - Drexel UniversityJasmine Sweeting - Drexel UniversityJoanna Lee - Drexel UniversityJ Rachael HaileSelasse - Drexel UniversityBrandy-Joe Milliron - Drexel University
- Publication Details
- American journal of kidney diseases, v 82(4), pp 419-428
- Publisher
- Elsevier
- Number of pages
- 10
- Grant note
- R01DK12438 8 / National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; Nutrition Sciences; Community Health and Prevention
- Web of Science ID
- WOS:001082784500001
- Scopus ID
- 2-s2.0-85163401395
- Other Identifier
- 991020426544004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Urology & Nephrology