Guidelines for the management of obesity in kidney disease

In a report published by the American Society of Nephrology and published online 18 Sept. in the Journal of the American Society of NephrologyGuidelines are provided for the management of obesity in individuals with kidney disease.

T. Alp Ikizler, MD, of Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues developed kidney health guidelines for treating obesity in people with kidney disease.

The authors note that weight loss can improve psychosocial functioning, including improved mood, higher quality of life, and slower progression of kidney disease, for patients with obesity and kidney disease. Effective obesity management remains a challenge for patients with kidney disease and requires a multidisciplinary team and a combination of multiple interventions.

Clinicians should address health-related social needs and identify and treat common mental health comorbidities. Patients should be treated with sensitivity, and clinicians should consider their prior experiences with trauma, racism, discrimination, and weight bias. Lifestyle modification is the first-line therapy for weight loss and should be implemented regardless of other therapeutic options being used.

Anti-obesity medications may be safe and beneficial for individuals with obesity and kidney disease, with incretin mimetics being the most effective and beneficial medications for individuals with kidney disease. There are few studies of metabolic/bariatric surgery conducted in individuals with kidney disease, but evidence suggests that kidney disease should not be considered a contraindication for these procedures.

“Although evidence for appropriate treatment of obesity in patients with kidney disease is increasing, gaps in knowledge and implementation require attention,” the authors write.

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