Bariatric surgery as an important step towards kidney transplantation in patients with morbid obesity and chronic kidney disease

An analysis of scientific studies devoted to the problem of bariatric surgery in patients with stages IIIb–V as chronic kidney disease (CKD) as the main step towardspossible kidney transplantation is presented. Obesity leads to CKD both directly, acting as an independent risk factor, and indirectly, by increasing the risk of diabetes, hypertension and atherosclerosis (i.e., a group of independent risk factors for CKD). CKD with an outcome of chronic renal failure is the second most common cause of mortality and disability in obese patients. In most kidney transplantation centers, a body mass index of more than 40 kg/m² is a contraindication for to transplantation (refusal to be included on the waiting list); and a body mass index of more than 35 kg/m² is a relative contraindication. In some cases, bariatric surgery is the only way to perform organ transplantation. Direct indications for bariatric surgery in patients with morbid obesity undergoing hemodialysis therapy have been identified. The established diet before/after bariatric surgery with the inclusion of protein isolate is not the cause of protein overload in patients with CKD. Bariatric surgery is considered a safe treatment option for obesity in potential kidney transplant candidates, given their continued need for immunosuppressive therapy.