Obesity Management Guide in Kidney Transplantation Patients in European Kidney Association!2021-11-27 00:06:25 25 ℃
In November 2021, the European Kidney Association (ERA) Working Group issued the management guidelines for kidney transplant candidates and obesity to guide the development of the final nephropathy (ESKD) and obese patients' management decisions. This guide includes risk layers, prognostic predictions, patient screening, and weight loss surgery.
When the kidney transplantation is evaluated, the waist or waist hip ratio (2C) should be measured in addition to the body mass index (BMI).
1. BMI defined obesity is ≥30kg / m2, and can be divided into level 1 obesity (30-34kg / m2), level 2 obesity (35-39 kg / m2) and level 3 obesity (≥40 kg / m2).
2. Waist Measurement can help physicians understand whether the patient is abdominal obesity (defined as male waist> 102cm, female waist> 88cm).
3. Abdominal obese waist and hip ratio is usually: male waist button ratio> 0.90, female waist hip ratio> 0.85.
1. BMI ESKD patients in 30-34kg / m2 can accept kidney transplantation (2C);
2. There is not enough clinical evidence to support higher BMI (≥ 35) patients (D);
3. Mission on obese ESKD patients, clarifying the risk of perioperative complications, including but not limited to graft function recovery delays, traumatic complications, acute risotics, diabetes (1C).
In addition, when discussing whether kidney transplantation is discussed, other risk factors of patients should be detailed.
1. For patients with ESKDs from 30-39.9kg / m2, if the patient is suitable for renal transplant surgery, then renal transplantation is the best treatment, regardless of whether the donor dies (2C);
2. For patients with ESKD in BMI at 30-39kg / m2, do not delay the kidney transplantation time (2C) only because of the increase in patient BMI.
Weight loss surgery
Kidney transplantation surgery
Encourage patients with kidney transplant with obesity to lose weight, and supervise (1D) by multidisciplinary weight management team;
For patients with kidney transplantation of BMI ≥ 40kg / m2, weight loss surgery is a treatment for consideration (2C);
For patients with kidney transplantation of BMI ≥ 35kg / m2, weight loss surgery will improve at least one merger (2D) related to obesity (2D);
For patients with kidney transplantation, the laparoscopic cuff stomach is superior to other weight loss surgery (2D).
The usual population of weight loss surgical indications are between BMI ≥ 40kg / m2 or BMI between 35-39kg / m2, and at least one complications related to obesity, such as type 2 diabetes, sleep apnea syndrome, non-alcoholic fat Liver or heart disease.
Renal transplantation surgery
For patients after renal transplant surgery, 2-4 recommendations before renal transplantation were consistent.
For patients after renal transplantation, the preferred non-surgical method for weight loss, if it is not possible to reach or maintain the weight loss target, weight loss surgery should be considered.
Although most chronic kidney disease and ESKD patients are related to malnutrition. However, some patients have more obesity. Existing studies have shown that obesity increases the risk of cardiovascular, metabolism and surgical complications in patients with kidney transplantation. Therefore, how to effectively assess whether obese patients can accept kidney transplantation. This recommendation can help medical workers better assess whether the obese ESKD population can kidney transplantation or weight loss surgery.
1.Oniscu GC, Abramowicz D, Bolignano D, et al Management ofobesity in kidney transplant candidates and recipients:. A clinical practiceguideline by the Descartes working group of ERA Nephrol Dial Transplant 2021Nov 12:.. Gfab310.
- In the previous：do you know?Why do lumbar discs always protrude from rear?
- The next article：Will you be afraid of cold?Expert reminder: winter glaucoma high
Guess you like
- 2022-01-19People who have a long-term drinking, want to prevent alcohol, "close", these 4 things must be aware
- 2022-01-19US study: most "side effects" that occur after vaccination new crown vaccine is not caused by vaccines
- 2022-01-19These 22 cases must be made in time to make a colonoscope, and An An Xin is a big year.
- 2022-01-19Chairman Mao often "does not cooperate with" doctors, once said to the health doctor: Confucius has stomach disease
- 2022-01-19Professor Yang Jiaxin | Correct assessment diagnosis is guaranteed, standardized diagnosis and treatment is the key!
- 2022-01-19"Science" heavy pounds: EB virus is actually the incentive of "no cancer"?
- 2022-01-19"", Fry!The woman is almost ... vigilant!This thing has many people in things.
- 2022-01-18Did you reach 4 standards to normal menstruation?
- 2022-01-18What are the similarities between 1 mysterious germs and new crown viruses every 2 people?
- 2022-01-18East China Medicine gets skingee soft capsules exclusively promote the collection of collects
- Does the bone implant metal?Doctor: It is necessary to depends on these factors!
- Pepper stewed pear, super power!I only know today ...
- Can running slim?Come over, you can lose weight, but it is easy to encounter a platform period.
- Popular: Winter new crown virus environmental communication risk large pilot tricks how to protect
- Li Jiaxin sent an ICU to rescue the risk of vegetative people, this disease is too scary.
- How to pick the staple food that is suitable for eating, see it!
- Go to the supermarket to buy, these 4 kinds of less, don't have nutritious and waste money, the shopping guide is rare!
- Frontier 丨 lung cancer diagnosis, quit smoking, survival rate can be increased by 29%
- In the past half of the month, nearly a thousand cases of the new crown have the greatest pressure.
- A woman in Hangzhou, "Eating Apple" every morning, how many changes have occurred in the time?