Nephrology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,
Biomedical Research Institute (IDIBELL), Hospital Duran i Reynals, L'Hospitalet de Llobregat, Spain,
Nephron. 2021;145(6):614-623. doi: 10.1159/000515786. Epub 2021 May 11.
Data from the WHO show an increasing rate of overweight and obesity in general population in the last decades. This increase in obesity also affects population with end-stage renal disease (ESRD) and kidney transplant (KT) candidates.
In this review, we focused on how obesity impacts on KT stages: access to KT and outcomes of KT candidates; how to reduce weight and its consequences; short and long-term outcomes in obese recipients and the impact of weight variations; and the implications of obesity in living donor KT. We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials until November 30, 2020. We selected systematic reviews and meta-analyses and randomized clinical trials. When no such reports were found for a topic, observational studies were included in the assessment. Key Messages: Although obesity is a risk factor to present worst outcomes after KT, several studies have demonstrated a survival benefit compared to patients who continue on dialysis. There is a need for a public health campaign to raise awareness in KT candidates and to highlight the importance of self-care, increasing exercise, healthy diet, and weight loss.
世界卫生组织的数据显示，在过去几十年中，普通人群的超重和肥胖率呈上升趋势。这种肥胖的增加也影响了终末期肾病（ESRD）患者和肾移植（KT）候选人群。
在这篇综述中，我们重点关注肥胖对 KT 各阶段的影响：KT 的准入和 KT 候选者的结果；如何减轻体重及其后果；肥胖受者的短期和长期结果以及体重变化的影响；以及肥胖对活体供者 KT 的影响。我们检索了 MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库，截至 2020 年 11 月 30 日。我们选择了系统评价和荟萃分析以及随机临床试验。对于某个主题，如果没有此类报告，则将观察性研究纳入评估。
尽管肥胖是 KT 后出现最差结果的危险因素，但多项研究表明，与继续接受透析的患者相比，肥胖患者具有生存获益。需要开展一项公共卫生运动，提高 KT 候选者的认识，并强调自我保健、增加锻炼、健康饮食和减肥的重要性。
