Weight loss in obese patients with chronic kidney disease: who and how?

Détails

ID Serval
serval:BIB_78E52B47698C
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Weight loss in obese patients with chronic kidney disease: who and how?
Périodique
Journal of Renal Care
Auteur(s)
Teta D.
ISSN
1755-6686 (Electronic)
ISSN-L
1755-6678
Statut éditorial
Publié
Date de publication
05/2010
Volume
36 Suppl 1
Pages
163-171
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
Obesity has adverse consequences in the general population. In patients with chronic kidney disease (CKD), it is associated with increased inflammation, insulin resistance, hypertension and dyslipidaemia, which are important risk factors for CKD progression and death. In adults with CKD stages 1-4, weight loss should be encouraged, it reduces proteinuria and glomerular hyperfiltration, which are frequent in obese patients. Proposals for modifications of lifestyle, physical activity and calorie restriction are the first measures. Pharmacological treatments are generally unsafe in these patients, except orlistat, but that has modest efficacy. Bariatric surgery may be the only option in severe obesity, if all other measures fail. For obese patients on dialysis treatment, who are eligible for kidney transplantation, weight loss is mandatory to prevent obesity-related surgical complications and improve patient and graft survival after transplantation. Interventions should place an emphasis on exercise to increase muscle mass, and calorie but not protein restriction. Bariatric surgery should be carried out by experienced surgeons due to the high risk of complications. For obese patients who are not considered transplant candidates the benefits of weight loss remain uncertain.
Mots-clé
Anti-Obesity Agents/adverse effects, Anti-Obesity Agents/therapeutic use, Bariatric Surgery/nursing, Combined Modality Therapy/nursing, Diet, Reducing/nursing, Exercise/physiology, Glomerular Filtration Rate/physiology, Humans, Kidney Failure, Chronic/nursing, Kidney Failure, Chronic/physiopathology, Kidney Transplantation/nursing, Lactones/adverse effects, Lactones/therapeutic use, Obesity/nursing, Obesity/physiopathology, Postoperative Complications/nursing, Postoperative Complications/prevention & control, Renal Dialysis/nursing, Risk Factors, Weight Loss/physiology
Pubmed
Création de la notice
16/01/2015 18:52
Dernière modification de la notice
20/08/2019 15:35
Données d'usage