Increasing Obesity Prevalence in the United States End-Stage Renal Disease Population
Increasing Obesity Prevalence in the United States End-Stage Renal Disease Population
复制标题
美国终末期肾病人群肥胖患病率不断上升
DOI：
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
B. Shelton
中科院分区：
文献类型：
--
作者：
B. Shelton
Obesity has become a national epidemic in the United States (US) [1,2]. Driven by a shift in diet over the last century and a more sedentary lifestyle, trends over time show that obesity prevalence is continuing to increase, not only in the US, but globally as well [3-8]. If current trends continue, projections show that by 2030, 20% of the world’s adult population will have obesity, and 38% will be overweight [9]. This trend is even more pronounced among the US population with 42-51% percent of the US population estimated to have obesity and 9-11% estimated to have severe obesity by 2030 [10]. Obesity is associated with an increased risk for developing multiple comorbidities, consequently increasing the disease burden overall [11]. Specifically, obesity is a risk factor for developing hypertension and diabetes, both of which are causes of end-stage renal disease (ESRD) [12,13]. Moreover, obesity itself may confer risk for development of chronic kidney disease (CKD) and ESRD [1416]. Given obesity’s association with comorbid disease development, Kramer et al. [14] examined the prevalence of obesity and changes in body mass index (BMI) among the ESRD population, revealing both have increased from 1995 to 2002. However, access to transplantation is restricted to those meeting center-specific BMI cutoffs, typically a BMI below 35 kg/m [17-22]. Thus, while obesity provides a survival advantage among dialysis patients, patients with a BMI in excess of 35 kg/m may not qualify for kidney transplantation until they lose weight [17,23-28]. Importantly, kidney transplantation provides a significant survival benefit among the general ESRD population and among the ESRD population with obesity, though it takes them longer to obtain that survival benefit due to higher risk of mortality early posttransplant [17,28-30]. When ESRD patients with obesity are offered transplant, they experience longer hospitalization, increased risk of surgical site infections, and higher rates of graft loss compared to their counterparts without obesity [3133]. In spite of these increased risks, kidney transplantation is cost-effective and thus, a preferential treatment option to dialysis [34,35]. However, Gill et al. [20] demonstrated in a 2014 study that women with a BMI of 25 kg/m or higher experienced lower likelihood of receiving a transplant as did men with a BMI of 35 kg/m or higher; Segev et al. [21] similarly reported an independent association between Abstract
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影响因子：
9.1
作者：
Park J;Ahmadi SF;Streja E;Molnar MZ;Flegal KM;Gillen D;Kovesdy CP;Kalantar-Zadeh K
通讯作者：
Kalantar-Zadeh K
影响因子：
8.3
作者：
HALL, JE;BRANDS, MW;SMITH, MJ
通讯作者：
SMITH, MJ
DOI：
10.2215/cjn.02080310
发表时间：
2010-12-01
影响因子：
9.8
作者：
Noori, Nazanin;Kopple, Joel D.;Kalantar-Zadeh, Kamyar
通讯作者：
Kalantar-Zadeh, Kamyar
DOI：
10.1016/j.mcna.2012.10.010
发表时间：
2013-01
期刊：
The Medical clinics of North America
影响因子：
--
作者：
Maric-Bilkan C
通讯作者：
Maric-Bilkan C