Raaijmakers Anke, Dooley Belinda, Sandery Blake, Chaturvedi Swasti, Le Jambre Renee, Links David, Kennedy Sean E
Department of Paediatric Nephrology, Sydney Children's Hospital Randwick, Randwick, Australia.
School of Women's and Children's Health, University of New South Wales, Randwick, Australia.
Pediatr Nephrol. 2025 Mar 18. doi: 10.1007/s00467-025-06661-0.
The prevalence of obesity in adolescents is rising, including in those with kidney failure. Obesity increases the risk of complications during dialysis and may be associated with poorer outcomes after transplantation. Bariatric surgery has been found safe and effective in adults on dialysis. This Clinical Insights is about a 14-year-old female with kidney failure and obesity. She was initially managed on peritoneal dialysis but subsequently gained further weight. Multiple interventions for weight loss were unsuccessful, including the switch to haemodialysis. The patient underwent laparoscopic sleeve gastrectomy after extensive multidisciplinary assessment. She lost > 30 kg over 6 months (BMI decreased from 48 to 32 kg/m) which made it possible for her to be activated on the deceased donor kidney transplant waiting list. Managing weight gain in patients on peritoneal dialysis is important, especially in obese adolescents. Bariatric surgery should be considered early where morbid obesity is a major impediment to listing for kidney transplantation.
青少年肥胖的患病率正在上升，包括肾衰竭青少年。肥胖会增加透析期间并发症的风险，并且可能与移植后较差的预后相关。减肥手术已被证明对接受透析的成年人是安全有效的。这篇临床见解是关于一名患有肾衰竭和肥胖症的14岁女性。她最初接受腹膜透析治疗，但随后体重进一步增加。包括改用血液透析在内的多种减肥干预措施均未成功。经过广泛的多学科评估后，该患者接受了腹腔镜袖状胃切除术。她在6个月内体重减轻超过30千克（BMI从48降至32千克/平方米），这使她能够被列入已故供体肾移植等待名单。控制腹膜透析患者的体重增加很重要，尤其是肥胖青少年。在病态肥胖成为肾移植登记的主要障碍时，应尽早考虑减肥手术。
