Diet, exercise may help some transplant candidates lose weight but fail ‘for majority’

Diet, exercise may help some transplant candidates lose weight but fail ‘for majority’
Diet, exercise may help some transplant candidates lose weight but fail ‘for majority’

Disclosures:
The authors report no related monetary disclosures.


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A conservative weight reduction program was efficient for a “small proportion” of kidney transplant candidates with weight problems, particularly those that had a decrease BMI at baseline.

The program — which consisted primarily of encouraging “wholesome consuming habits and better power expenditure” — led to a imply change in physique weight of three.8%.

Weight loss program for transplant candidates
Infographic content material was derived from Hajjar R, et al. J Ren Nutrit. 2021;doi:10.1053/j.jrn.2021.03.005.

“Despite the vast majority of [kidney transplantation] KT packages utilizing a BMI restrict [most commonly 35 kg/m2], solely a minority (31%) reported the usage of a proper weight reduction program,” Roy Hajjar, MD, of the division of surgical procedure at Hôpital Maisonneuve-Rosemont in Montréal, and colleagues wrote. “Even in our personal program beforehand, the help offered for potential candidates to realize the BMI restrict was negligible.”

To assess the influence of a conservative administration weight reduction program for this affected person inhabitants, researchers included 80 sufferers with kidney illness (BMI of greater than 35 kg/m2) who had been referred for transplantation. Throughout this system, individuals acquired counseling on consuming habits and train (eg, encouraging three small meals a day and 10 to fifteen minutes on a stationary bicycle or treadmill every morning), with no pharmacological choices supplied. Anthropometric measurements had been taken each 3 months. Weight loss was thought of “profitable” for individuals who lowered their BMI to lower than 35 kg/m2.

After a imply follow-up of 24 months, 26.3% skilled profitable weight reduction, whereas 7.5% skilled important weight acquire (BMI enhance of greater than 3 kg/m2). In complete, 31.3% of sufferers gained weight (common enhance in BMI of 1.9 kg/m2).

Researchers discovered ladies and sufferers who had been initially nearer to the BMI restrict had been most certainly to attain weight reduction leading to BMI of lower than 35 kg/m2; no sufferers with a baseline BMI of greater than 40 kg/m2 reached this goal.

Results of a complete dietary analysis administered to a subset of 44 sufferers revealed that 14.6% had beforehand acquired dietary counseling for weight reduction.

“Weight loss via weight loss program and train, as the primary therapy choice to accessing the KT ready record, could not generate an immense quantity of pleasure or hope,” Hajjar and colleagues wrote. “This examine attests to the perceived futility with a imply change in physique weight of three.8% … As a coverage for the overweight candidate, conservative weight reduction fails for almost all and can’t be the only therapy choice.”

Despite this, the researchers contended it “shouldn’t be missed” that some sufferers succeeded in this system.

“Because shut follow-up could result in increased affected person adherence, dietary counseling and follow-ups might additional be applied in the course of the extra common dialysis periods to make sure compliance and enhance motivation,” the researchers wrote.

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