Current opinion in organ transplantation · 2026
Management of the kidney transplant candidate with obesity.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Abbasi Ali B, Orandi Babak J
Аннотация
PURPOSE OF REVIEW: Nearly half of all patients listed for kidney transplant now have obesity, which is associated with increased rates of perioperative complications and graft loss. Here, we provide an update on the management of obesity in patients with end-stage kidney disease (ESKD).
RECENT FINDINGS: Lifestyle interventions are the backbone of obesity therapy but may be challenging to implement in transplant candidates due to dietary and activity limitations associated with ESKD and hemodialysis. Antiobesity medications (AOMs) acting on the glucagon-like peptide-1 receptor can result in weight loss up to 22% of total body weight, but evidence in ESKD is limited and their long-term use is limited by a high burden of gastrointestinal side effects and inconsistent insurance coverage. In terms of metabolic and bariatric surgery (MBS), the procedure of choice in transplant candidates is sleeve gastrectomy, which can result in weight loss up to 23% at 1 year and is associated with a lower risk of malabsorption and late complications, and possibly improved mortality compared to Roux-en-Y gastric bypass.
SUMMARY: Lifestyle interventions, AOMs, and MBS are important options for transplant candidates with obesity, but more evidence is needed to define optimal treatment pathways involving AOMs and MBS in this population.
RECENT FINDINGS: Lifestyle interventions are the backbone of obesity therapy but may be challenging to implement in transplant candidates due to dietary and activity limitations associated with ESKD and hemodialysis. Antiobesity medications (AOMs) acting on the glucagon-like peptide-1 receptor can result in weight loss up to 22% of total body weight, but evidence in ESKD is limited and their long-term use is limited by a high burden of gastrointestinal side effects and inconsistent insurance coverage. In terms of metabolic and bariatric surgery (MBS), the procedure of choice in transplant candidates is sleeve gastrectomy, which can result in weight loss up to 23% at 1 year and is associated with a lower risk of malabsorption and late complications, and possibly improved mortality compared to Roux-en-Y gastric bypass.
SUMMARY: Lifestyle interventions, AOMs, and MBS are important options for transplant candidates with obesity, but more evidence is needed to define optimal treatment pathways involving AOMs and MBS in this population.