Hossain Mohammed, Woywodt Alexander, Augustine Titus, Sharma Videha
Department of Nephrology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Clin Kidney J. 2017 Oct;10(5):703-708. doi: 10.1093/ckj/sfx022. Epub 2017 Apr 22.
A 56-year-old female patient was referred to the transplant assessment clinic in July 2016. She started haemodialysis in 2012 for renal failure due to urinary tract infections. She is doing very well on dialysis and has an excellent exercise tolerance without shortness of breath or angina. She has had no infections since starting dialysis and no other comorbidity, except well-controlled hypertension and hyperparathyroidism requiring treatment with cinacalcet. Clinical examination is essentially normal except for truncal obesity with height 167 cm and weight 121 kg, giving her a body mass index of 43.4. Can she be listed for a renal transplant? If not, which target weight should be given to the patient before she can be transplant listed? Which interventions, if any, should be recommended to achieve weight loss?
一名56岁女性患者于2016年7月被转诊至移植评估诊所。她在2012年因尿路感染导致肾衰竭开始进行血液透析。她透析情况良好，运动耐量极佳，无呼吸急促或心绞痛症状。自开始透析以来，她未发生感染，也无其他合并症，仅有控制良好的高血压和需要使用西那卡塞治疗的甲状旁腺功能亢进。除了身高167厘米、体重121千克的躯干肥胖（体重指数为43.4）外，临床检查基本正常。她可以被列入肾移植名单吗？如果不行，在她能够被列入移植名单之前，应该给患者设定怎样的目标体重？应该推荐哪些干预措施（如有）来实现体重减轻？
