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Impact of obesity on dialysis and transplant and its management
Author(s) -
Diwan Tayyab S.,
Cuffy Madison C.,
LinaresCervantes Ivan,
Govil Amit
Publication year - 2020
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12876
Subject(s) - medicine , peritoneal dialysis , dialysis , intensive care medicine , obesity , hemodialysis , kidney transplantation , nephrology , population , overweight , kidney disease , transplantation , peritonitis , environmental health
Abstract Obesity is increasing to unprecedented levels, including in the end‐stage kidney disease population, where upwards of 60% of kidney transplant patients are overweight or obese. Obesity poses additional challenges to the care of the dialysis patient, including difficulties in creating vascular access and inserting Tenckhoff catheters, higher rates of catheter malfunction and peritonitis, the need for longer and/or more frequent dialysis (or peritoneal dialysis [PD] exchanges) to achieve adequate clearance, increased metabolic complications particularly with PD, and obesity is a barrier to kidney transplantation. In this article, we review special considerations in performing PD, hemodialysis and transplant in the obese patient, as well as the evidence behind medical and surgical management of obesity in dialysis patients.