TY - JOUR
T1 - Approaches to Obesity Management in Dialysis Settings
T2 - Renal Dietitian Perspectives
AU - Suresh, Aditi
AU - Robinson, Lucy
AU - Milliron, Brandy Joe
AU - Leonberg, Kristin
AU - McAdams-DeMarco, Mara
AU - Earthman, Carrie
AU - Klassen, Ann
AU - Harhay, Meera N.
N1 - Funding Information:
Support: M.N.H. receives grant/research support from the National Institutes of Health ( National Institute of Diabetes and Digestive and Kidney Diseases : K23DK105207 ). M.M.-D. receives grants/research support from the National Institutes of Health ( National Institute of Diabetes and Digestive and Kidney Diseases : R01DK120518 , R01DK114074 and National Institute on Aging : R01AG055781 ). Funding organizations had no role in any aspect of the research or manuscript preparation.
PY - 2020/11
Y1 - 2020/11
N2 - Objectives: Over 40% of individuals in the United States with end-stage kidney disease have obesity. Little is known about renal dietitian perspectives on obesity management in the setting of dialysis dependence. Design and methods: An online 21-item survey was distributed to 118 renal dietitians via individual outreach and a professional organization e-mail listserv. Four themes were explored: the burden of obesity among dialysis patients, concepts of healthy weight loss, weight loss approaches, and challenges of obesity management in dialysis settings. Respondents were asked to rank approaches and biomarkers for obesity management from 0 (least important or not used) to 100 (most important). Free text fields were provided in each category for additional comments. Results: Thirty-one renal dietitians responded to the survey (26% response rate). The majority of respondents (90%) indicated that access to kidney transplantation was the main reason that dialysis patients with obesity desired weight loss. Calorie restriction was rated as the most common weight loss approach, and dry weight as the most important weight loss biomarker. Nearly 40% of respondents do not alter their nutritional approach when dialysis patients with obesity are losing weight, and 42% of respondents do not monitor changes in waist circumference. Exercise, diet counseling, and stress management were variably prioritized as weight loss management strategies. Barriers to obesity management in dialysis settings included lack of time, lack of training in weight loss counseling, and gaps in current renal nutritional guidelines. Conclusion: Despite the high prevalence of obesity among individuals with end-stage kidney disease, the results of this survey suggest that current approaches to obesity management in dialysis settings are highly variable. Many renal dietitians lack time to counsel patients on healthy weight loss strategies. Nutritional guidelines are also needed to support people with dialysis dependence and obesity who desire or require weight loss.
AB - Objectives: Over 40% of individuals in the United States with end-stage kidney disease have obesity. Little is known about renal dietitian perspectives on obesity management in the setting of dialysis dependence. Design and methods: An online 21-item survey was distributed to 118 renal dietitians via individual outreach and a professional organization e-mail listserv. Four themes were explored: the burden of obesity among dialysis patients, concepts of healthy weight loss, weight loss approaches, and challenges of obesity management in dialysis settings. Respondents were asked to rank approaches and biomarkers for obesity management from 0 (least important or not used) to 100 (most important). Free text fields were provided in each category for additional comments. Results: Thirty-one renal dietitians responded to the survey (26% response rate). The majority of respondents (90%) indicated that access to kidney transplantation was the main reason that dialysis patients with obesity desired weight loss. Calorie restriction was rated as the most common weight loss approach, and dry weight as the most important weight loss biomarker. Nearly 40% of respondents do not alter their nutritional approach when dialysis patients with obesity are losing weight, and 42% of respondents do not monitor changes in waist circumference. Exercise, diet counseling, and stress management were variably prioritized as weight loss management strategies. Barriers to obesity management in dialysis settings included lack of time, lack of training in weight loss counseling, and gaps in current renal nutritional guidelines. Conclusion: Despite the high prevalence of obesity among individuals with end-stage kidney disease, the results of this survey suggest that current approaches to obesity management in dialysis settings are highly variable. Many renal dietitians lack time to counsel patients on healthy weight loss strategies. Nutritional guidelines are also needed to support people with dialysis dependence and obesity who desire or require weight loss.
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U2 - 10.1053/j.jrn.2020.01.021
DO - 10.1053/j.jrn.2020.01.021
M3 - Article
C2 - 32144072
AN - SCOPUS:85081370363
VL - 30
SP - 561
EP - 566
JO - Journal of Renal Nutrition
JF - Journal of Renal Nutrition
SN - 1051-2276
IS - 6
ER -