Obesity and bariatric intervention in patients with chronic renal disease
Obesity and bariatric intervention in patients with chronic renal disease
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DOI：
10.1177/0300060519843755
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发表时间：
2019-06-01
影响因子：
1.6
通讯作者：
Herbert, Paul Elliot
中科院分区：
文献类型：
--
作者：
Bellini, Maria Irene;Paoletti, Filippo;Herbert, Paul Elliot
肥胖与慢性代谢疾病有关，这些疾病直接或间接导致肾实质损伤。对文献进行了回顾，以探讨肥胖与慢性肾脏疾病之间关系的现有证据，以及减肥手术在改善高体重指数患者肾移植中的作用。该综述显示，没有明确的证据支持使用仅基于体重指数的移植资格截止参数。此外，在移植前的情况下，肥胖悖论与肥胖患者比非肥胖患者更好的生存率相关，尽管减肥手术的结果很有希望。然而，在获得更多关于肥胖肾移植候选人结局改善的信息之前，临床医生应重点筛查移植候选人的整体虚弱状况，以确保他们的资格并加入等待名单。
Obesity is associated with chronic metabolic conditions that directly and indirectly cause kidney parenchymal damage. A review of the literature was conducted to explore existing evidence of the relationship between obesity and chronic kidney disease as well as the role of bariatric surgery in improving access to kidney transplantation for patients with a high body mass index. The review showed no definitive evidence to support the use of a transplant eligibility cut-off parameter based solely on the body mass index. Moreover, in the pre-transplant scenario, the obesity paradox is associated with better patient survival among obese than non-obese patients, although promising results of bariatric surgery are emerging. However, until more information regarding improvement in outcomes for obese kidney transplant candidates is available, clinicians should focus on screening of the overall frailty condition of transplant candidates to ensure their eligibility and addition to the wait list.