Losing Weight; The Experience of Patients With End Stage Kidney Disease: A Qualitative Study

Abstract

Background: Patients with end-stage kidney disease need renal replacement therapy to ensure survival. Kidney transplant is superior to dialysis due to better survival. Patients with obesity cannot be approved for kidney transplant until they lose sufficient weight. Obesity may complicate the surgical procedure, and the risk of graft loss increases with increasing body mass index. Attaining appropriate weight loss is often a hindrance for transplantation for the patient with obesity, and further knowledge of minds, thoughts and attitudes are necessary to better help these patients to lose weight.Methods: Semi-structured interviews with patients who needed to lose weight to be approved to the kidney transplant list at a Danish hospital, were recorded and transcribed. From patients’ responses, we identified descriptive categories using a phenomenological approach. Factors affecting outcomes were derived reflexively from these categories.Results: Ten interviews were analyzed. Experiences of obesity and weight-loss attempts were described across 4 categories; (i) Restrictions and exhaustion, (ii) Hope and hopelessness, (iii) Support and self-discipline, and (iv) Motivation based on severity.Conclusions: Patients with obesity that hinders kidney transplantation need additional help with the dietary restrictions that follow a kidney disease. They need bridging between a kidney-friendly diet and a sustainable diet that will ensure weight-loss. These patients also express how they do not want to be alone in their weight-loss battle. They are looking for help, camaraderie and support to obtain weight-loss.