Obesity as a barrier to kidney transplantation: Time to eliminate the body weight bias?

Abstract:

:There is clear evidence that survival rates following transplantation far exceed those for remaining on dialysis, regardless of body size measured by body mass index (BMI). Studies over the past 15 years also suggest little to no difference in long-term outcomes, including graft survival and mortality, irrespective of BMI, in contrast to earlier evidence. However, weight bias still exists, as access to kidney transplantation remains inequitable in centers using arbitrary BMI limits. Clinicians faced with the decision regarding listing based on body size are not helped by conflicting recommendations in national and international guidelines. Therefore, in clinical practice, obesity, and recommendations for weight loss, remain a controversial issue when assessing suitability for kidney transplantation. Obesity management interventions in end-stage kidney disease (ESKD), whether for weight loss for transplantation listing or for slowing kidney disease progression, are under-explored in trial settings. Bariatric surgery is the most successful treatment for obesity, but carries increased risk in the ESKD population, and the desired outcome of kidney transplant listing is not guaranteed. Centers that limit transplants to those meeting arbitrary levels of body mass, rather than adopting an individualized assessment approach, may be unfairly depriving many ESKD patients of the survival and quality of life benefits derived from kidney transplantation. However, robotic kidney transplantation surgery holds promise for reducing perioperative risks related to obesity, and may therefore represent an opportunity to remove listing criteria based on size.

journal_name

Semin Dial

journal_title

Seminars in dialysis

authors

MacLaughlin HL,Campbell KL

doi

10.1111/sdi.12783

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

219-222

issue

3

eissn

0894-0959

issn

1525-139X

journal_volume

32

pub_type

社论
  • Dietary vitamin D intake in advanced CKD/ESRD.

    abstract::In healthy individuals, vitamin D produced in the skin or derived from nutritional sources is converted to 25-hydroxyvitamin D (25[OH]D) in the liver, and then 1,25-dihydroxyvitamin D (1,25[OH](2)D) by 1 alpha-hydroxylase in the kidney. Chronic kidney disease (CKD) is accompanied by a progressive decline in the abilit...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2010.00751.x

    authors: Bhan I,Hewison M,Thadhani R

    更新日期:2010-07-01 00:00:00

  • Use of warfarin in people with low glomerular filtration rate or on dialysis.

    abstract::Atrial fibrillation, venous thromboembolism, and access malfunction are common clinical problems in dialysis patients that prompt consideration of warfarin therapy. Atrial fibrillation appears to be more common in people with low glomerular filtration rate (GFR) or on dialysis than in the general population, but the r...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2009.00632.x

    authors: Holden RM,Clase CM

    更新日期:2009-09-01 00:00:00

  • Percutaneous technique of presternal peritoneal dialysis catheter placement.

    abstract::Presternally exiting peritoneal dialysis (PD) catheters have been described as advantageous compared to abdominally exiting catheters with regard to infection, wound healing, and other complications. Placement of such catheters has only been described with open surgical techniques and not by percutaneous means. In thi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.0894-0959.2004.17356.x

    authors: Sreenarasimhaiah VP,Margassery SK,Martin KJ,Bander SJ

    更新日期:2004-09-01 00:00:00

  • Withholding and withdrawal from dialysis: what we know about how our patients die.

    abstract::Withholding and withdrawal of dialysis has been a reality since dialysis was invented. Only in the past 20 years has it been formally studied, and we still have a great deal to learn. The nephrology community has slowly come to accept that, for some of our patients, not having dialysis is a better option than continui...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2007.00273.x

    authors: Germain MJ,Cohen LM,Davison SN

    更新日期:2007-05-01 00:00:00

  • Comparison of peritoneal dialysis catheter insertion techniques by nephrologists: Surgical vs blind methods.

    abstract:BACKGROUND:The aim of the present study was to perform a comparative analysis of peritoneal dialysis catheter (PDC) insertion between blind and surgical methods by nephrologists. PATIENTS AND METHODS:The present study enrolled 249 peritoneal dialysis patients who received first-time PDC insertion. All PDC insertions w...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12904

    authors: Kang SH,Park JW,Cho KH,Do JY

    更新日期:2020-07-23 00:00:00

  • Prevention and treatment of hemodialysis-related bloodstream infections.

    abstract::Despite improvements in the delivery of care, the annual all-cause mortality rate for end-stage renal disease (ESRD) patients is still around 220 deaths per 1000 at risk patient-years. Infection-related causes are second only to cardiovascular events as a cause for mortality among ESRD patients. Almost two-thirds of a...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12117

    authors: Camins BC

    更新日期:2013-07-01 00:00:00

  • The association of hepatitis C infection with the onset of CKD and progression into ESRD.

    abstract::Hepatitis C virus (HCV) infection is not only an important cause of chronic liver disease, but extrahepatic manifestations are common and include chronic kidney disease (CKD). HCV is classically associated with cryoglobulinemic glomerulonephritis in the context of mixed cryoglobulinemia syndrome, but other glomerular ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12759

    authors: Henson JB,Sise ME

    更新日期:2019-03-01 00:00:00

  • Beta blockers in patients with end-stage renal disease-Evidence-based recommendations.

    abstract::For patients who require hemodialysis, beta blockers offer a simultaneous opportunity and challenge in the treatment of cardiovascular disease. Beta blockers are well supported by data from nondialysis populations and directly mitigate the sympathetic overactivity that links chronic kidney disease with cardiovascular ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12691

    authors: Weir MA,Herzog CA

    更新日期:2018-05-01 00:00:00

  • Improving access to renal transplantation.

    abstract::Kidney transplantation is the treatment of choice for most patients with end-stage renal disease (ESRD), with success rates greater than were envisioned as recently as a decade ago. Unfortunately this trend has created unprecedented demand for transplantable organs and new challenges for those desiring transplantation...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2005.00093.x

    authors: Gaston RS

    更新日期:2005-11-01 00:00:00

  • In-center hemodialysis education: Challenges and innovations in training of fellows in nephrology.

    abstract::The in-center dialysis unit and practice of dialysis, in the current multi-team approach, requires knowledge and skills in all the domains including medical expert, communicator, collaborator, scholar, health advocate, and leader. We are tasked as a community, to embrace and incentivize new innovations and technology ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12668

    authors: Moist LM,Lindsay RM

    更新日期:2018-03-01 00:00:00

  • Experimental studies on computed tomographic peritoneography. Peritoneal and residual renal function tolerance to iodinated contrast media injected into the peritoneal cavity.

    abstract::Computed tomographic (CT) peritoneography has been widely used as reference standard to evaluate continuous ambulatory peritoneal dialysis-related complications. However, given the varying CT peritoneography approaches used across different institutions, there is no standard value for non-ionic iodinated contrast medi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12867

    authors: Bai J,Dong J,Shu J,Xu Y,Ding W,Chen J

    更新日期:2020-03-01 00:00:00

  • Inflammatory biomarkers and cardiovascular risk: association or cause and effect?

    abstract::With the current understanding that atherosclerosis is an inflammatory disorder, markers of the associated systemic inflammatory response have been extensively studied as predictors of cardiovascular disease. Recently the use of high-sensitivity C-reactive protein (hsCRP) has been proposed for risk assessment in indiv...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2006.00138.x

    authors: Rao M,Jaber BL,Balakrishnan VS

    更新日期:2006-03-01 00:00:00

  • Removal of Phosphorus by Hemodialysis.

    abstract::The control of serum phosphorus by dialysis is made difficult by the fact that intradialytic blood levels tend to be low, and because phosphorus is removed almost exclusively from the plasma during its passage through the dialyzer. The most practical way to increase phosphorus removal is to extend dialysis time, altho...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12439

    authors: Daugirdas JT

    更新日期:2015-11-01 00:00:00

  • Lipid abnormalities associated with end-stage renal disease.

    abstract::Patients undergoing chronic renal replacement therapy have a high incidence of dyslipidemia. In general, there are increased concentrations of triglyceride-rich apolipoprotein B-containing particles. These elevations lead to increased levels of non-high-density lipoprotein (HDL) levels. This pattern is further modifie...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2006.00117.x

    authors: Liu J,Rosner MH

    更新日期:2006-01-01 00:00:00

  • The economic burden of geriatric ESRD.

    abstract::The elderly represent the fastest growing segment of incident patients entering end-stage renal disease (ESRD). Increasingly, social scientists and caregivers are faced with changing models of care, which will challenge traditional patterns of patient acceptance into costly medical therapies. This paper analyzes the o...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12015

    authors: Parker TF 3rd

    更新日期:2012-11-01 00:00:00

  • Dialysis bone disease.

    abstract::The bone disease associated with end-stage renal failure (ESRD) and treatment are complex and multifactorial, and has changed in both clinical and imaging features over the past three decades. Whereas previously features of vitamin D deficiency (rickets/osteomalacia) and intense, and prolonged, secondary hyperparathyr...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2002.00073.x

    authors: Adams JE

    更新日期:2002-07-01 00:00:00

  • Salvage of problematic peritoneal dialysis catheters.

    abstract::Peritoneal dialysis (PD) is a markedly underutilized modality for permanent renal replacement therapy in the United States owing to a low rate of patient referral and high rate of patient dropout or transfer to hemodialysis. One cause for patient loss from PD is problematic PD catheters that often are removed rather t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2006.00148.x

    authors: Asif A,Gadalean F,Vieira CF,Hogan R,Leon C,Merrill D,Ellis R,Amador A,Broche O,Bush B,Contreras G,Pennell P

    更新日期:2006-03-01 00:00:00

  • Conservative treatment of the uremic syndrome.

    abstract::In addition to extracorporeal renal replacement strategies, which in chronic kidney disease (CKD) are largely reserved for the treatment of end-stage kidney failure, conservative measures can be taken to reduce concentration, effects, or both concentration and effects of uremic retention solutes. In this overview, we ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2009.00600.x

    authors: Vanholder R,Argilés A,Beige J,Brunet P,Drüeke TB,Fliser D,Herget-Rosenthal S,Hörl WH,Jörres A,Perna A,Rodriguez-Portillo M,Spasovski G,Stegmayr B,Stenvinkel P,Wanner C,Wiecek A,Massy ZA

    更新日期:2009-07-01 00:00:00

  • Influence of temporal variation in wall shear stress on intima-media thickening in arteriovenous fistulae.

    abstract::Arteriovenous fistula (AVF) failure is mainly due to venous stenosis characterized by significant amount of intima-media thickening (IMT), probably in the presence of negative (inward) remodeling. Our hypothesis is that the longitudinal changes in wall shear stress (WSS) within different configurations of AVF can infl...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12045

    authors: Rajabi-Jagahrgh E,Krishnamoorthy MK,Wang Y,Choe A,Roy-Chaudhury P,Banerjee RK

    更新日期:2013-07-01 00:00:00

  • Eliminating the need for routine monthly postdialysis serum urea nitrogen measurement: A method for monitoring Kt/V and normalized protein catabolic rate using conductivity determined dialyzer clearance.

    abstract::Many dialysis machines can compute dialyzer sodium clearances at multiple time points during a dialysis treatment using conductivity. For a given treatment, the average dialyzer sodium clearance (K), when combined with treatment time (t), and the estimated urea distribution volume (V, usually based on either anthropom...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12750

    authors: Daugirdas JT

    更新日期:2018-11-01 00:00:00

  • Comments on plasma parathyroid hormone levels and their relationship to bone histopathology among patients undergoing dialysis.

    abstract::Measurements of the concentration of parathyroid hormone (PTH) in serum or plasma are used widely for the initial diagnostic assessment of patients with renal bone disease, to monitor disease progression, and to gauge responses to treatment. Several analytical methods are used to measure plasma PTH levels, and a varie...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审

    doi:10.1111/j.1525-139X.2007.00230.x

    authors: Goodman WG

    更新日期:2007-01-01 00:00:00

  • ESRD-induced dyslipidemia-Should management of lipid disorders differ in dialysis patients?

    abstract::Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Although numerous modifiable risk factors in the pathogenesis of CVD and its associated mortality have been identified, dyslipidemia remains to be a key focus for therapy. In this regard, significant progress has been made in reducing ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12706

    authors: Moradi H,Streja E,Vaziri ND

    更新日期:2018-07-01 00:00:00

  • We Underdose Antibiotics in Patients on CRRT.

    abstract::Appropriate antibiotic dosing in critically ill, infected, patients receiving continuous renal replacement therapy (CRRT) is crucial to improve patient outcomes. Severe sepsis and septic shock result in changes in pharmacokinetic parameters, including increased volume of distribution, hypoalbuminemia, and changes in r...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12496

    authors: Shaw AR,Chaijamorn W,Mueller BA

    更新日期:2016-07-01 00:00:00

  • Drug therapy for hypertension in hemodialysis patients.

    abstract::The majority of end-stage renal disease (ESRD) patients are hypertensive. Drug therapy for hypertension in hemodialysis (HD) patients includes all classes of antihypertensive drugs, with the sole exception of diuretics. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers may decrease mo...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.0894-0959.2004.17329.x

    authors: Hörl MP,Hörl WH

    更新日期:2004-07-01 00:00:00

  • Chronic peritoneal dialysis patients diagnosed with clinical depression: results of pharmacologic therapy.

    abstract::Depression has been documented as the most frequently encountered psychological problem in end-stage renal disease (ESRD) patients and has been correlated with both mortality and morbidity in these patients. Previous work by our group has shown that clinical depression is treatable with psychotropic medications in the...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1046/j.1525-139x.2003.16094.x

    authors: Wuerth D,Finkelstein SH,Kliger AS,Finkelstein FO

    更新日期:2003-11-01 00:00:00

  • Blood pressure control in conventional hemodialysis.

    abstract::Hypertension among patients on hemodialysis is common, difficult to diagnose and often inadequately controlled. Although specific blood pressure (BP) targets in this particular population are not yet established, meta-analyses of randomized trials showed that deliberate BP-lowering with antihypertensive drugs improves...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12741

    authors: Georgianos PI,Agarwal R

    更新日期:2018-11-01 00:00:00

  • Consolidation in dialysis Markets-Causes, consequences, and the role of policy.

    abstract::The dialysis industry is one of the most highly concentrated healthcare sectors in the United States. Despite decades of growth in the number of patients with end-stage renal disease and in the size of dialysis markets, two large dialysis organizations currently care for more than two-thirds of the dialysis population...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12855

    authors: Saeed MK,Ho V,Erickson KF

    更新日期:2020-01-01 00:00:00

  • Extracorporeal treatment of cast nephropathy.

    abstract::Acute kidney injury (AKI) is common in patients with multiple myeloma (MM), most commonly caused by cast nephropathy resulting from precipitation of free light chains (FLC) in renal tubules. AKI may be irreversible and require dialysis and predicts a poor prognosis. Reduction in serum FLC concentration is thought to b...

    journal_title:Seminars in dialysis

    pub_type: 社论

    doi:10.1111/j.1525-139X.2010.00814.x

    authors: Gakhar B,Kobrin S,Berns JS

    更新日期:2011-01-01 00:00:00

  • Sympathetic overactivity in dialysis patients-Underappreciated and clinically consequential.

    abstract::Cardiovascular morbidity and mortality remain frustratingly common in dialysis patients. A dearth of established evidence-based treatment calls for alternative therapeutic avenues to be embraced. Sympathetic hyperactivity, predominantly due to afferent nerve signaling from the diseased native kidneys, has been establi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12756

    authors: Hoye NA,Wilson LC,Jardine DL,Walker RJ

    更新日期:2019-05-01 00:00:00

  • Retrospective analysis of catheter recirculation in prevalent dialysis patients.

    abstract::Catheter recirculation (CR) occurs when blood returning from the venous limb of the catheter re-enters the arterial limb of the catheter without passage through the circulation. Adequacy of dialysis is influenced by the degree of access recirculation. In this study we evaluate factors influencing the degree of dialysi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2008.00442.x

    authors: Moossavi S,Vachharajani TJ,Jordan J,Russell GB,Kaufman T,Moossavi S

    更新日期:2008-05-01 00:00:00