Background

Prior to being approved for transplant, patients (pts) with end stage kidney disease (ESRD) must undergo a rigorous evaluation to determine if their health status will allow for performance of a safe transplant. Because obesity increases the risk for complications and rejection of the organ, many transplant programs have BMI cutoffs. Even though all ESRD pts have nutritional programs, pts without programs for weight loss and exercise do not lose weight and are never listed for transplant. These pts are sedentary, as they are required to sit in a dialysis chair an average of 12 hours a week. Fitness Formula Clubs and the University of Chicago Medicine completed a two-year study which encouraged participants to make lifelong changes that will help them improve outcomes even after a transplant.The goal of the study was to assist patients in weight loss so they could be placed on the kidney transplant list.

Methods

Pts with a BMI over 45 were approached to participate.Pts were interviewed using a “willingness to change” tool. 20 patients were pre-screened and 12 were approved Patients participated in classes and worked with a dietician and trainer. They worked on rowing machines and treadmills. All activities were tailored for the individual patient.

Results

Of the 12 patients approved, 6 completed the program. 5 lost weight and were able to be listed for a transplant. Testimonials for pts showed satisfaction and an overall improvement in health markers such as documentation inn food and activity diaries. Participants reported that their attitude toward their own health improved and their belief in their own abilities to participate in exercise was solidified.

Conclusions

Weight loss can be achieved in patients with chronic illnesses. Critical components of success include dedication on the part of the patient as well as removal of barriers by the healthcare system at large.