A modest weight-loss program was effective for a “small minority” of obese kidney transplant candidates, those who had a low BMI at baseline.
The program primarily consisted of encouraging “healthy eating habits and higher energy expenditure” and led to an average change in body weight of 3.8%.
“Despite the majority, [kidney transplantation] KT program using BMI limits [most commonly 35 kg/m2]Only a minority (31%) reported using a formal weight loss program. ” Dr. Roy Hajjar, and colleagues from the Department of Surgery at Maisonneuve-Rosemont Hospital in Montreal wrote: “Even in our previous proprietary program, very little support was provided to potential candidates to achieve the BMI limit.”
To assess the impact of a conservatively managed weight loss program on this patient population, researchers enrolled 80 patients with kidney disease (BMI ≥35 kg/m3).2) Persons referred for transplantation. Throughout the program, participants receive dietary and exercise counseling (e.g., encouragement to eat three small meals a day and run on a stationary bike or treadmill for 10 to 15 minutes each morning) and are not provided with pharmaceutical options. There wasn't. Anthropometric measurements were performed every 3 months. Participants whose BMI decreased to less than 35 kg/m were considered to have “successful” weight loss.2.
After an average follow-up of 24 months, 26.3% successfully lost weight and 7.5% experienced significant weight gain (BMI increase of 3 kg/m or more).2). In total, 31.3% of patients gained weight (mean increase in BMI was 1.9 kg/m2).2).
The researchers found that women and patients who were initially near the BMI limit were most likely to achieve weight loss, resulting in a BMI below 35 kg/m2.2;No patient had baseline BMI > 40 kg/m2 We achieved this goal.
A comprehensive nutritional assessment performed on a subset of 44 patients revealed that 14.6% had previously received nutritional counseling for weight loss.
“As the primary treatment option for accessing the KT waiting list, weight loss through diet and exercise may not generate immense excitement or hope,” Hajjar and colleagues wrote. “This study proves that the average change in body weight is perceived as wasteful by 3.8%…As a policy for obese candidates, conservative weight loss is failing for the majority; It cannot be the only treatment option.”
Nevertheless, the researchers insisted that the success of some patients with the program “should not be overlooked.”
“As close follow-up can lead to improved patient adherence, further dietary counseling and follow-up could be implemented during more regular dialysis sessions to ensure compliance and increase motivation.” ” the researchers wrote.
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