Should Body Mass Index (BMI) Still Be Seen As The Single Gold Standard For CKD Patients?

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Chronic Kidney Disease (CKD) patients are considered obese if they are 30 or more above their recommended medical weight (Body Mass Index). Often obese CKD patients are told that they may jeopardize their treatment plan and are considered a poor candidate to receive a Kidney Transplant if their Body Mass Index (BMI) is greater than 35. Many people with CKD go to extreme measures to cut the extra pounds including excessive workouts, skipping meals and even surgery. In a twist of sad irony, these weight loss strategies can put people with CKD at higher risk of suffering very significant side effects including hospitalization and death. What's more, is that many CKD specific studies are revealing a paradox between High BMI and IMPROVED survival outcomes in CKD patients, specifically dialysis patients.

Recommended Reading: Is Being A Little Overweight Beneficial To Individuals Suffering With Chronic Kidney Disease? 

While being excessively over weight is bad, recent studies are suggesting that being a bit over your BMI, the gold standard for CKD patients, may have some very important health benefits. The Examiner busted a few health myths related to weight of which CKD patients should be aware.

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First, a high BMI does not mean you NEED to lose weight. According to the Examiner, current BMI readings do not differentiate between weight in muscle and fat. While having a BMI number over 25 is considered overweight, and over 30 is considered obese, Arnold Schwarzenegger, had a BMI of 33 at the peak of his body-building career. This example is only meant to highlight that the BMI reading should not be the only gauge to determine your health. 

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In fact, people who are a bit above their BMI (25-30) have been shown to survive heart attacks and surgery more than those with lower BMIs. Researchers go further and suggest that people who are slightly overweight are also less likely to die from respiratory diseases, Alzheimer’s, liver disease, and a number of other causes than people of normal weight. However, those that are clearly considered obese do have higher risks of heart disease mortality compared to normal weight or "overweight" people.

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Even overweight people can actually be fit. Fitness is partly based on how quickly your heart rate returns to normal after exertion

(the quicker the heart can recover, the better shape you are in). Researchers now believe that overweight people with fatty liver deposits are at much greater cardiovascular and diabetes risk than overweight people without them. 

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The looming BMI number may lead people with CKD to believe that weight loss is always good by any means. This is not true. Drastic diets can put strain on your heart and disturb your metabolism. If you are overweight and are dieting it is much better to work with your Dietitian and lose weight in a slow, steady and metered way (no more than one pound a week is recommended). "Researchers are now advising that it is better to be 5-10lbs. overweight than to engage in unhealthy weight loss plans." 

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All of the pressure to meet their exact BMI give CKD patients a lot of anxiety and emotional stress. This in turn can lead to other major issues such as increased blood pressure and risk of heart attack or stroke. Yet the fact is that you cannot determine anyone's health, including that of CKD patients by how slender they are. For instance, thin people may still carry unhealthy visceral fat that pads vital organs, putting them at risk of heart disease, diabetes and cancer. KidneyBuzz.com still strongly believes that all of its readers remain physically active, abide by their diet plan and follow their Healthcare Team's treatment plan because if you are only slightly overweight but still active, you may be less likely to experience health problems like high cholesterol or heart disease. 

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References: 

Trader, Lois. "Myths Busted about Heart Disease and Fat." Http://www.examiner.com/. Clarity Digital Group LLC D/b/a Examiner.com.

"Weight-Loss Dieting When You're on Dialysis ." Http://www.davita.com/. DaVita HealthCare Partners Inc.

"Weight Loss Surgery Effective in Kidney Disease Patients, but Side Effects Are High." Http://www.newswise.com/. American Society of Nephrology (ASN). 

McGinnis -González, Sherri. "Robotic Transplant an Option for Obese Kidney Patients." Http://news.uic.edu/. University of Illinois Medical Center.