Concerned Your Weight is Disqualifying You from a Kidney Transplant?: Weight Qualifying Strategies

If you are overweight then you are not alone. Increasing numbers of individuals with End-Stage Renal Disease are overweight which places many patients in jeopardy of not qualifying for a kidney transplant. All transplant centers have body weight guidelines for potential transplant patients because being above your desired body mass index makes surgery more complicated and risky. Also, many patients gain significant amounts of weight after their transplants and can develop serious medical conditions as a result of excess weight. For example, studies have found that people overweight who receive kidney transplants are at increased risk of wound infections, transplant failure and heart disease during their recovery.

Recommended Reading: Tailored Treatment Plans required to combat Protein Energy Wasting for CKD recommends that you make reasonable lifestyle modifications to manage your weight, increase chances of receiving a kidney transplant and improve overall health outcomes. You will likely face both physical and emotional challenges when attempting to achieve your weight-loss goals including anemia, after treatment limitations, diet restrictions, and emotional stress.

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You may often suffer anemia due to low red blood cell count which will cause fatigue, shortness of breath and dizziness. If you have anemia, ask your doctor to tell you when your blood count is high enough for you to exercise and diet safely. Similarly, after hemodialysis you may feel weak and lack motivation to exercise. Sometimes this will last for only a few hours while other times it will require a full day's rest. It is best to plan exercise on days you do not do dialysis or after you have completely recovered from your treatment. If you are on Peritoneal Dialysis (PD) then you usually have the time and ability to exercise, so this should be a consistent part of your routine. Discuss with your Nephrologist whether you should exercise with an empty abdomen rather than one filled with fluid. Your dietitian can assist you to create a low caloric diet to ensure you consume enough low-fat, high quality protein and maintain your albumin levels as well as body muscle.

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At times you may be insecure about your ability to lose weight and feel like it is an impossible feat. In this case you should remember weight loss does not happen overnight and trying to make huge changes all at once can become discouraging. Instead set small achievable goals, use a "buddy" system to have someone remind you of your goals, and reward yourself when they are accomplished. Overtime this will amount to overall big success!

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Still, some cannot lose weight or do not see the success they desire over long periods of time. In cases such as these, the morbidly obese (over 100lbs. of ideal body weight) may consider gastric bypass. This option should be thoroughly discussed with your Nephrologist and a Specialist, but most dialysis patients who conduct this procedure are able to go home two to three days after the surgery. You will find that often times the surgeon performing the gastric bypass in patients with kidney failure is also a transplant surgeon who is familiar with your special needs. University of California, San Francisco found that this surgery can be performed safely and may save the lives of morbidly obese dialysis and transplant patients.

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Although maintaining weight as a ESRD patient is no more or less difficult than for those with healthy kidneys, maintaining their weight for a dialysis patient is extremely important. You should note that your weight may affect not only your chances of being selected for a kidney transplant, under current guidelines, but also interfere with the success of the transplant. Thus you should work with your healthcare team to manage your weight in the healthiest way possible that best suits your personal lifestyle. 

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"Surgical Weight Loss Procedures for Kidney Transplant Patients." UCSF Medical Center.  

"Obese Patients Urged to Lose Weight Before Kidney Transplant." US News. U.S.News & World Report