The direct association of obesity with overall health is incontrovertible, including an association with increased cardiovascular disease and higher mortality rates. The health outcomes of obesity are further exacerbated in patients with end-stage kidney disease (ESKD), and compounding this problem, the one intervention that can dramatically improve life span, kidney transplant, is often not offered to these patients. Lassalle et al1 showed that patients with a body mass index (calculated as weight in kilograms divided by height in meters squared) of 31 or more were less likely to receive a kidney transplant, and inversely, for every 1-point reduction in body mass index, the likelihood of kidney transplant increased 9% to 11%. The reason why surgeons withhold kidney transplant from patients with obesity is because of an increased risk of delayed graft function, allograft loss, and patient mortality.2,3 Yet, there is a distinct survival advantage for patients with ESKD if they undergo kidney transplant, because the transplant potentially extends life by 7 to 11 years, depending on the causative mechanism of kidney failure.4 Therefore, there is a critical need for weight loss interventions for this patient population.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Kibbe MR, Gerber DA. Bariatric Surgeons Should Operate on Patients With Obesity Who Are Receiving Dialysis. JAMA Surg. 2020;155(7):588–589. doi:10.1001/jamasurg.2020.0862
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: