Rationale & Objective: Patients with kidney failure need kidney replacement therapy to maximize survival. Kidney transplant is a superior mode of kidney replacement therapy for most individuals with kidney failure. Patients with obesity often are not approved for kidney transplant until they lose sufficient weight, as obesity may complicate the surgical procedure, and the risk of graft loss increases with a higher body mass index. To help potential kidney transplant recipient candidates lose weight, further knowledge of their thoughts, feelings, and attitudes is needed.
Study Design: Qualitative study with semistructured interviews and an exploratory research design, guided by qualitative content analysis.
Setting & Participants: Patients at a hospital in Denmark required to lose weight to achieve kidney transplant eligibility.
Analytical Approach: From patients' responses, we identified descriptive themes using a phenomenological approach. The factors affecting outcomes were derived reflexively from these themes.
Results: Ten interviews were analyzed. Experiences of obesity and weight-loss attempts were described across 4 themes; (1) restrictions and exhaustion, (2) hope and hopelessness, (3) support and self-discipline, and (4) motivation based on severity. A major motivating factor to achieving weight loss in the studied group of patients was their declining kidney function and the fact that kidney transplant cannot be considered until sufficient weight loss is achieved.
Limitations: Thematic saturation was reached after an unexpectedly low number of participants. The patients were only interviewed once and over the phone.
Conclusions: Patients with obesity who are seeking kidney transplant need additional help with the dietary restrictions brought on by kidney disease. They need assistance bridging between a kidney-friendly diet and a sustainable diet that will ensure weight loss. These patients also express not wanting to feel alone in their weight-loss battle. They are looking for help and support to achieve weight loss.
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http://dx.doi.org/10.1016/j.xkme.2021.09.005 | DOI Listing |
J Nephrol
January 2025
Department of Medicine, Surgery and Neurosciences, Nephrology, Dialysis and Transplantation Unit, University Hospital of Siena, Siena, Italy.
Background: Renal functional reserve (RFR) measures the difference between the stimulated glomerular filtration rate (GFR) and the baseline GFR to detect early signs of renal functional decline. The protein load test (RFR-T) is the gold standard for RFR assessment but is a complicated procedure. Renal intraparenchymal resistance index (RRI) variation test (DRRI-T) is a non-invasive method to measure renal function reserve using ultrasound.
View Article and Find Full Text PDFTransplant Proc
January 2025
Nephrology, Hospital Universitario Donostia, San Sebastián, España.
Hemophagocytic lymphohistiocytosis is a potentially fatal multisystemic inflammatory syndrome that is better understood in the pediatric population. Consequently, the diagnostic criteria for adults still derives from studies conducted in the pediatric population. Several genetic mutations and secondary causes, including infections, autoimmunity, and malignancy, have been reported as significant actors in this condition, especially in adults.
View Article and Find Full Text PDFBr J Anaesth
January 2025
Population Health Research Institute, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
Background: Optimised use of kidney function information might improve cardiac risk prediction in noncardiac surgery.
Methods: In 35,815 patients from the VISION cohort study and 9219 patients from the POISE-2 trial who were ≥45 yr old and underwent nonurgent inpatient noncardiac surgery, we examined (by age and sex) the association between continuous nonlinear preoperative estimated glomerular filtration rate (eGFR) and the composite of myocardial injury after noncardiac surgery, nonfatal cardiac arrest, or death owing to a cardiac cause within 30 days after surgery. We estimated contributions of predictive information, C-statistic, and net benefit from eGFR and other common patient and surgical characteristics to large multivariable models.
Nat Rev Nephrol
January 2025
Department of Kidney and Transplant Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Transplant Proc
January 2025
Servicio de Nefrología, Hospital Universitario La Paz, Madrid, Spain.
Background: Patients on a kidney transplant waiting list with antibodies against more than 80% of a panel reactive antibody (PRA) are difficult to transplant, even with national or regional programs. Desensitization treatment with high-dose intravenous immunoglobulin and rituximab could be offered to patients with a long waiting time for a cadaveric donor to improve their odds of finding a kidney.
Methods: This was a retrospective, single-center study including all hyperimmunized patients on the waiting list for a cadaveric kidney donor who received a desensitization treatment between 2010 and 2020.
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