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Patient and Health Care Professional Perspectives on Addressing Obesity in ESKD
Journal article   Open access   Peer reviewed

Patient and Health Care Professional Perspectives on Addressing Obesity in ESKD

Meera Nair Harhay, Ann C Klassen, Bengucan Gunen, Sneha Hingorany, Jasmine Sweeting, Joanna Lee, J Rachael HaileSelasse and Brandy-Joe Milliron
American journal of kidney diseases, v 82(4), pp 419-428
01 Oct 2023
DOI: https://doi.org/10.1053/j.ajkd.2023.02.005
PMID: 37086964
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1053/j.ajkd.2023.02.005View
Accepted (AM)Open Access (Publisher-Specific),  Open

Abstract

dialysis weight loss Obesity
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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31 Record Views
10 citations in Web of Science
4 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Urology & Nephrology
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