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Renal transplant bariatric

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https://www.readbyqxmd.com/read/28439568/bariatric-surgery-and-kidney-related-outcomes
#1
Alex R Chang, Morgan E Grams, Sankar D Navaneethan
The prevalence of severe obesity in both the general and the chronic kidney disease (CKD) populations continues to rise, with more than one-fifth of CKD patients in the United States having a body mass index of ≥35 kg/m(2). Severe obesity has significant renal consequences, including increased risk of end-stage renal disease (ESRD) and nephrolithiasis. Bariatric surgery represents an effective method for achieving sustained weight loss, and evidence from randomized controlled trials suggests that bariatric surgery is also effective in improving blood pressure, reducing hyperglycemia, and even inducing diabetes remission...
March 2017: KI Reports
https://www.readbyqxmd.com/read/28405876/laparoscopic-sleeve-gastrectomy-in-kidney-transplant-candidates-a-case-series
#2
Sergio Carandina, Laurent Genser, Manuela Bossi, Laura Montana, Alexandre Cortes, Marie Seman, Marc Danan, Christophe Barrat
BACKGROUND: Patients with a body mass index (BMI) >35 kg/m(2) who need kidney transplant present with increased postoperative mortality and reduced kidney graft survival compared to patients with a lower BMI. For this reason, obese patients are often excluded from the transplantation waiting list. The aim of this study was to evaluate the feasibility and the results of laparoscopic sleeve gastrectomy (LSG) for obese patients awaiting a kidney transplant. METHODS: This was a retrospective study on patients with dialysis-dependent renal failure (DDRF) operated on at two first-level bariatric centers in Paris (France)...
April 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28260459/bariatric-surgery-in-renal-transplant-patients
#3
Osama Gheith, Torki Al-Otaibi, Medhat A Halim, Tarek Mahmoud, Ahmed Mosaad, Jude Yagan, Zakaria Zakaria, Suzann Rida, Prasad Nair, Rashad Hassan
OBJECTIVES: The idea of transplanting organs is not new, nor is the disease of obesity. Obese transplant recipients have greater risk of early death than their cohorts, which is not due to increased rejection but due to obesity-related complications, including arterial hypertension, diabetes, and delayed graft function. Here, our aim was to evaluate the effects of bariatric surgery versus lifestyle changes on outcomes of moderate to severely obese renal transplant recipients. MATERIALS AND METHODS: Twenty-two morbidly obese patients with stable graft function who underwent bariatric surgery were compared with 44 obese patients on lifestyle management (control group)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28217701/gut-microbiota-and-oxalate-homeostasis
#4
Marguerite Hatch
This perspective focuses on how the gut microbiota can impact urinary oxalate excretion in the context of hyperoxaluria, a major risk factor in kidney stone disease. In the genetic disease of Primary Hyperoxaluria Type 1 (PH1), an increased endogenous production of oxalate, due to a deficiency of the liver enzyme alanine-glyoxylate aminotransferase (AGT), results in hyperoxaluria and oxalate kidney stones. The constant elevation in urinary oxalate in PH1 patients ultimately leads to tissue deposition of oxalate, renal failure and death and the only known cure for PH1 is a liver or liver-kidney transplant...
January 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28139330/management-of-the-obese-kidney-transplant-candidate
#5
REVIEW
Julie Lesage, John S Gill
Obesity is an increasingly common condition that can exclude end stage renal disease patients from consideration of kidney transplantation. The optimal management of obese transplant candidates is uncertain, especially the use of pharmacologic therapies or bariatric surgery. We review the rationale to consider transplantation in obese patients, the impact of obesity on access to kidney transplantation, the evidence for obese patients to lose weight loss prior to kidney transplantation, peri-operative management considerations and specific weight loss strategies prior to transplantation...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28122320/revisional-bariatric-surgery-in-a-transplant-patient
#6
Salman Al Sabah, Eliana Al Haddad
INTRODUCTION: A BMI of over 35-45kg/m2 is deemed the upper limit for considering a patient for a renal transplant. Voluntary weight loss attempts are a major concern for patients while on hemodialysis, however, bariatric surgeries have opened up a new door to notable weight loss results, even demonstrating significant improvements of patients' diabetic profile and hypertension. CASE REPORT: Case of a 52-year-old male with a BMI of 42 in end-stage renal disease, that needed a kidney transplant but was ineligible to be placed on the waiting list due to his weight...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27410399/recurrence-of-hyperoxaluria-and-kidney-disease-after-combined-intestine-kidney-transplantation-for-enteric-hyperoxaluria
#7
Burcin Ekser, Richard S Mangus, Chandrashekhar A Kubal, Jonathan A Fridell, John A Powelson, Santosh Nagaraju, Plamen Mihaylov, Carrie L Phillips, Romil Saxena, William C Goggins
BACKGROUND: Enteric hyperoxaluria (EH) occurs with a rate of 5-24% in patients with inflammatory bowel disease, ileal resection and modern bariatric surgery. The excessive absorption of calcium oxalate causes chronic kidney disease (CKD) in patients with EH. In the literature, a single experience was reported in combined intestine-kidney transplantation (CIKTx) in patients with CKD due to EH. METHODS: After a report of 2 successful cases of CIKTx in patients with EH and CKD, one was performed at our center in a 59-year-old Caucasian female who developed intestinal failure with total parenteral nutrition (TPN) dependence after a complication post-bariatric surgery...
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27234772/successful-management-of-new-onset-diabetes-mellitus-and-obesity-with-the-use-of-laparoscopic-sleeve-gastrectomy-after-kidney-transplantation-a-case-report
#8
J-H Chen, C-H Lee, C-M Chang, W-Y Yin
In kidney transplantation, obesity is associated with poorer graft survival and patient survival. Bariatric surgery may provide benefit for these patients, not only by inducing weight loss, but also via reduction of diabetes. We report a case of morbid obesity, poorly controlled new-onset diabetes mellitus, and gout after kidney transplantation that was treated with laparoscopic sleeve gastrectomy 3 years after kidney transplantation. After 1 year of follow-up, 76% excessive body weight loss was attained. No complications were noted...
April 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/26941053/is-bariatric-surgery-in-patients-following-renal-transplantation-safe-and-effective-a-best-evidence-topic
#9
Nancy Hadjievangelou, Myutan Kulendran, Emma Rose McGlone, Marcus Reddy, Omar A Khan
Obesity is common amongst patients with renal transplants (RT). It is associated not only with generic obesity-related complications including diabetes, but also with higher rates of graft rejection and loss. A Best Evidence Topic in surgery was written according to a structured protocol: this is a systematic review of the literature, suitable when the quality of available evidence is low. The question addressed was: is weight-loss surgery (WLS) safe and effective in patients that have had a previous renal transplant? Three prospective case series and one multicentre retrospective study were identified, together reporting on a total of 112 patients who underwent WLS after RT...
April 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/26823089/sleeve-gastrectomy-surgery-in-obese-patients-post-organ-transplantation
#10
Enrique F Elli, Raquel Gonzalez-Heredia, Lisa Sanchez-Johnsen, Neil Patel, Raquel Garcia-Roca, Jose Oberholzer
BACKGROUND: Among organ transplant recipients, a common side effect of immunosuppressive therapy is the development of obesity, which affects a third of the patients within 3 years after transplantation. Bariatric surgery represents a possible surgical option for weight loss among posttransplant patients. OBJECTIVES: The aim of this study was to examine percent excess weight loss (%EWL), and percent weight loss (%WL) and perioperative and postoperative complications in posttransplant obese patients after sleeve gastrectomy (SG) compared with nontransplant patients...
March 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/26787788/role-of-cardiopulmonary-exercise-testing-as-a-risk-assessment-method-in-patients-undergoing-intra-abdominal-surgery-a-systematic-review
#11
REVIEW
J Moran, F Wilson, E Guinan, P McCormick, J Hussey, J Moriarty
BACKGROUND: Cardiopulmonary exercise testing (CPET) is used as a preoperative risk-stratification tool for patients undergoing non-cardiopulmonary intra-abdominal surgery. Previous studies indicate that CPET may be beneficial, but research is needed to quantify CPET values protective against poor postoperative outcome [mortality, morbidity, and length of stay (LOS)]. METHODS: This systematic review aimed to assess the ability of CPET to predict postoperative outcome...
February 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26359199/pro-pretransplant-weight-loss-yes
#12
Krista L Lentine
The obesity epidemic has not spared the population with renal failure. Obesity impacts prognosis after kidney transplantation, as markers of obesity are associated with worse outcomes (e.g. delayed graft function, graft failure, cardiovascular disease, costs) compared with ideal values in most studies. Obesity is also potentially modifiable. Kidney transplants are a scarce resource and the obligation to steward organs to good outcomes is inherent in transplant practice. Thus, it is appropriate to establish pretransplant weight loss targets and engage obese patients seeking transplantation in shared responsibility agreements to strive to reach goals...
November 2015: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/26236496/the-impact-and-treatment-of-obesity-in-kidney-transplant-candidates-and-recipients
#13
Gabriel Chan, Pierre Garneau, Roy Hajjar
The prevalence of obesity in patients with chronic kidney failure and renal transplant candidates has paralleled the epidemic in the general population. The associated risks of surgical complications and long-term cardiovascular death are significant: most transplant centers consider obesity a relative contra-indication for transplant. Few studies have focused on conservative weight loss strategies in transplant patients. Studies using administrative databases have found that only a minority of wait-listed patients lose weight and with no apparent benefit to transplant outcomes...
2015: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/25963131/body-mass-index-and-outcome-in-renal-transplant-recipients-a-systematic-review-and-meta-analysis
#14
REVIEW
Jeffrey A Lafranca, Jan N M IJermans, Michiel G H Betjes, Frank J M F Dor
BACKGROUND: Whether overweight or obese end stage renal disease (ESRD) patients are suitable for renal transplantation (RT) is often debated. The objective of this review and meta-analysis was to systematically investigate the outcome of low versus high BMI recipients after RT. METHODS: Comprehensive searches were conducted in MEDLINE OvidSP, Web of Science, Google Scholar, Embase, and CENTRAL (the Cochrane Library 2014, issue 8). We reviewed four major guidelines that are available regarding (potential) RT recipients...
May 12, 2015: BMC Medicine
https://www.readbyqxmd.com/read/25813752/safety-and-effectiveness-of-bariatric-surgery-in-dialysis-patients-and-kidney-transplantation-candidates
#15
Mohammad H Jamal, Ricard Corcelles, Christopher R Daigle, Tomasz Rogula, Matthew Kroh, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Chronic renal disease is known to adversely affect the results of bariatric surgery. There is a paucity of literature on the safety and effectiveness of bariatric surgery on dialysis patients who are at very advanced stages in their renal disease. The objective of this study was to determine the safety and effectiveness of bariatric surgery in dialysis patients. METHODS: A retrospective review of a prospectively collected database was conducted for dialysis patients who underwent bariatric surgery between January 2006 and January 2012...
March 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/25711520/the-first-polish-liver-transplantation-after-roux-en-y-gastric-bypass-surgery-for-morbid-obesity-a-case-report-and-literature-review
#16
REVIEW
Rafał Marszałek, Paweł Ziemiański, Beata Łągiewska, Marek Pacholczyk, Justyna Domienik-Karłowicz, Janusz Trzebicki, Zbigniew Wierzbicki, Krzysztof Jankowski, Maciej Kosieradzki, Dariusz Wasiak, Maurycy Jonas, Piotr Pruszczyk, Magdalena Durlik, Wojciech Lisik, Andrzej Chmura
BACKGROUND: Morbid obesity is associated with liver pathology, most commonly non-alcoholic steatohepatitis (NASH) leading to cirrhosis. However, the morbid obesity impedes qualification for organ transplantation. CASE REPORT: We present a case report of a 56-year-old woman who underwent bariatric procedure followed by liver transplantation (LTx). Her initial weight was 130.2 kg (BMI 50.9 kg/m2). The patient had a history of arterial hypertension, diabetes, gonarthrosis, and obstructive sleep apnea syndrome and no history of alcohol abuse...
2015: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/25483934/improvement-of-graft-function-following-roux-en-y-gastric-bypass-surgery-in-a-morbidly-obese-kidney-recipient-a-case-report-and-literature-review
#17
REVIEW
Paweł Ziemiański, Wojciech Lisik, Rafał J Marszałek, Tomasz Cieciura, Justyna Domienik-Karłowicz, Janusz Trzebicki, Tomasz Gryczewski, Zbigniew Wierzbicki, Maciej Kosieradzki, Magdalena Durlik, Piotr Pruszczyk, Andrzej Chmura
BACKGROUND: Transplantation is the best and approved method of renal replacement therapy. Graft function depends not only on proper regulation of immune processes but also on the optimal control of chronic diseases. The obesity epidemic involves the healthy population and organ recipients equally. Obesity and metabolic syndrome lead to a number of disorders exerting adverse effects on the transplanted organ. CASE REPORT: We report a case of a kidney recipient, 12 years after transplantation, with chronic graft failure (serum creatinine level 2...
December 8, 2014: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/25139661/laparoscopic-sleeve-gastrectomy-as-a-weight-reduction-strategy-in-obese-patients-after-kidney-transplantation
#18
I Golomb, J Winkler, A Ben-Yakov, C C Benitez, A Keidar
Morbid obesity is associated with increased graft loss and shortened graft survival in kidney transplant patients. Treating obesity in transplant patients may improve graft outcomes. Laparoscopic sleeve gastrectomy (LSG), an effective bariatric operation, is relatively unlikely to interfere with absorption of anti-rejection medications. Data on relevant renal function parameters were collected from all LSGs performed on renal transplant patients at our center (n = 10). The procedure was successful in eight patients, with no mortality, graft rejection or dysfunction...
October 2014: American Journal of Transplantation
https://www.readbyqxmd.com/read/25032099/transplant-options-for-patients-with-type-2-diabetes-and-chronic-kidney-disease
#19
REVIEW
Costas Fourtounas
Chronic kidney disease (CKD) has become a real epidemic around the world, mainly due to ageing and diabetic nephropathy. Although diabetic nephropathy due to type 1 diabetes mellitus (T1DM) has been studied more extensively, the vast majority of the diabetic CKD patients suffer from type 2 diabetes mellitus (T2DM). Renal transplantation has been established as a first line treatment for diabetic nephropathy unless there are major contraindications and provides not only a better quality of life, but also a significant survival advantage over dialysis...
June 24, 2014: World Journal of Transplantation
https://www.readbyqxmd.com/read/24507957/obesity-metabolic-syndrome-and-diabetes-mellitus-after-renal-transplantation-prevention-and-treatment
#20
REVIEW
Karl Martin Wissing, Lissa Pipeleers
The prevalence of the metabolic syndrome in dialysis patients is high and further increases after transplantation due to weight gain and the detrimental metabolic effects of immunosuppressive drugs. Corticosteroids cause insulin resistance, hyperlipidemia, abnormal glucose metabolism and arterial hypertension. The calcineurin inhibitor tacrolimus is diabetogenic by inhibiting insulin secretion, whereas cyclosporine causes hypertension and increases cholesterol levels. Mtor antagonists are responsible for hyperlipidemia and abnormal glucose metabolism by mechanisms that also implicate insulin resistance...
April 2014: Transplantation Reviews
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