The Obesity Society (TOS) and the National Kidney Foundation (NKF) have partnered to publish a unique paper that it hopes will contribute to a better understanding of the relationship between coexisting obesity and chronic kidney disease. (IRC).
Released Oct. 21, the NKF and TOS special report highlights findings, particularly identified opportunities and barriers, from a multi-specialty international scientific workshop held in 2021 with key opinion leaders in nephrology, medicine from obesity, diabetes, endocrinology, bariatric surgery, and more.
“The rationale for the workshop was for nephrologists to learn more about obesity from physicians who specialize in the treatment of obesity, and for obesity experts to better understand how kidney disease might affect obese people. “said report author Allon N. Friedman, MD, of the Division of Nephrology, School of Medicine, Indiana University, in a statement. “The workshop provided an opportunity for clinicians and scientists from diverse fields to work together and begin to identify challenges and opportunities in improving the care of patients with obesity and CKD.”
A testament to the evolution of the field of cardiorenal metabolism, the 11-page document provides an overview of the most prevalent opportunities, barriers and research needs in the management of concurrent obesity and CRF on the contemporary database. Composed by Friedman and a team of 9 colleagues, the document cites 58 references and is broken down into 6 sections devoted to barriers to optimal obesity management, strategies for improving patient engagement in obesity management, strategies for engaging nephrologists and obesity specialists in obesity management, strategies to address knowledge gaps, and conclusion of the document.
To aid in the understanding of the document, the editorial board has composed several figures and graphs dedicated to the description of the pathophysiology of coexisting obesity and CKD as well as an overview of the complications of obesity associated with each stage. progress of the IRC. In addition to these graphics, the Editorial Board has also provided a set of 4 boxes outlining potential approaches for each of the above sections regarding strategies to improve management, engage patients, or fill knowledge gaps. In the box on strategies for improving obesity management in people with CKD, the researchers recommended:
- Design strategies to help identify CKD in the setting of obesity and weight loss.
- Develop criteria for when and how to best treat obesity.
- To educate nephrologists on the importance, role and effective management of obesity.
- Educate obesity specialists on why, when and how to screen for kidney disease.
- Identify useful measures beyond BMI to assess obesity-related health risks.
- Develop recommendations that balance competing dietary needs in patients with CKD.
- Address the social factors influencing obesity.
- Formulate strategies to improve insurance coverage and weight management reimbursement.
The report emphasizes the authors’ belief that the engagement strategies of nephrologists and obesity medicine experts were more likely to succeed if they establish common ground, with the authors suggesting that a first step to improve engagement would be increased recognition of obesity as a chronic disease. disease with specific pathophysiology that clinicians can target with pharmacological and surgical options. Other recommendations to improve patient engagement included:
- Educate patients about the interrelationship between obesity and CKD.
- Educate and reassure patients about the biological basis of their obesity.
- Expand obesity support groups to include the CKD population.
- Use non-stigmatizing and non-prejudicial language when discussing obesity.
“Obesity is arguably the single most important risk factor in the 21st century for the development and progression of CKD. It is also a major cause in people with pre-existing CKD of worse health outcomes and lower quality of life,” Friedman added.
The study, titled “Obstacles and Opportunities in Managing Coexisting Obesity and CKD: Report of a Scientific Workshop Cosponsored by the National Kidney Foundation and The Obesity Society,” will be published in Obesity.