{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:27:50Z","timestamp":1791174470045,"version":"4.1.0"},"reference-count":154,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Both obesity and chronic kidney disease (CKD) are increasingly recognized as global epidemics. Their escalating incidence and far-reaching health implications highlight the urgent need for comprehensive prevention and management strategies. This review aims to clarify how obesity interacts with end-stage kidney disease (ESKD) and how to improve the management of obese patients receiving kidney replacement therapy. It also explores underlying mechanisms, current treatments, future directions, and ongoing controversies. By highlighting this intricate relationship, the review seeks to enhance clinical practice and promote further research toward more personalized care for this vulnerable population. Obesity is frequent in dialysis patients and creates challenges related to body composition, metabolism, and treatment. While higher body mass index (BMI) may appear to improve survival, this paradox does not offset the cardiovascular and functional risks of visceral and sarcopenic obesity. Obesity also increases post-transplant complications and can limit access to transplantation. Lifestyle changes rarely achieve lasting weight loss, whereas bariatric surgery\u2014especially sleeve gastrectomy\u2014can improve transplant eligibility with fewer complications. Weight-loss medications may be used before transplantation but remain insufficiently studied in ESKD. After transplantation, weight-reduction efforts should continue, with pharmacotherapy preferred over bariatric surgery. Comprehensive assessment strategies and individualized management approaches in ESKD patients are essential to optimize outcomes in this growing patient population.<\/jats:p>","DOI":"10.3390\/medicina62010211","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:27:58Z","timestamp":1768908478000},"page":"211","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Obesity and Its Clinical Implications in End-Stage Kidney Disease"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7295-0174","authenticated-orcid":false,"given":"Kristina","family":"Petruliene","sequence":"first","affiliation":[{"name":"Department of Nephrology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alanta","family":"Zilinskiene","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruta","family":"Vaiciuniene","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kestutis","family":"Vaiciunas","sequence":"additional","affiliation":[{"name":"Department of Urology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga Arune","family":"Bumblyte","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egle","family":"Dalinkeviciene","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/S0140-6736(24)01210-8","article-title":"Obesity in adults","volume":"404","author":"Lingvay","year":"2024","journal-title":"Lancet"},{"key":"ref_2","unstructured":"(2025, December 08). Obesity and Overweight. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_3","unstructured":"(2025, March 04). World Obesity Atlas 2025. Available online: https:\/\/www.worldobesity.org\/resources\/resource-library\/world-obesity-atlas-2025."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.kisu.2021.11.003","article-title":"Epidemiology of chronic kidney disease: An update 2022","volume":"12","author":"Kovesdy","year":"2022","journal-title":"Kidney Int. Suppl."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/j.kint.2019.07.012","article-title":"A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases","volume":"96","author":"Jager","year":"2019","journal-title":"Kidney Int."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kreiner, F.F., Schytz, P.A., Heerspink, H.J.L., von Scholten, B.J., and Idorn, T. (2023). Obesity-Related Kidney Disease: Current Understanding and Future Perspectives. Biomedicines, 11.","DOI":"10.3390\/biomedicines11092498"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kotsis, V., Martinez, F., Trakatelli, C., and Redon, J. (2021). Impact of Obesity in Kidney Diseases. Nutrients, 13.","DOI":"10.3390\/nu13124482"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1038\/nrneph.2016.75","article-title":"Obesity-related glomerulopathy: Clinical and pathologic characteristics and pathogenesis","volume":"12","author":"Chagnac","year":"2016","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e70042","DOI":"10.1111\/dme.70042","article-title":"Obesity-related glomerulopathy: How it happens and future perspectives","volume":"42","author":"Tan","year":"2025","journal-title":"Diabet. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Herrington, W.G., Smith, M., Bankhead, C., Matsushita, K., Stevens, S., Holt, T., Hobbs, F.D.R., Coresh, J., and Woodward, M. (2017). Body-mass index and risk of advanced chronic kidney disease: Prospective analyses from a primary care cohort of 1.4 million adults in England. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0173515"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"21","DOI":"10.7326\/0003-4819-144-1-200601030-00006","article-title":"Body mass index and risk for end-stage renal disease","volume":"144","author":"Hsu","year":"2006","journal-title":"Ann. Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1038\/ki.2014.384","article-title":"Obesity, metabolic health, and the risk of end-stage renal disease","volume":"87","author":"Panwar","year":"2015","journal-title":"Kidney Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1053\/j.ajkd.2009.03.023","article-title":"Prehypertension, obesity, and risk of kidney disease: 20-year follow-up of the HUNT I study in Norway","volume":"54","author":"Munkhaugen","year":"2009","journal-title":"Am. J. Kidney Dis."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pan, D., Li, G., Jiang, C., Hu, J., and Hu, X. (2023). Regulatory mechanisms of macrophage polarization in adipose tissue. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1149366"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/imr.12853","article-title":"Adipose tissue macrophages: Unique polarization and bioenergetics in obesity","volume":"295","author":"Caslin","year":"2020","journal-title":"Immunol. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3892\/mmr.2024.13219","article-title":"Molecular and pathophysiological relationship between obesity and chronic inflammation in the manifestation of metabolic dysfunctions and their inflammation-mediating treatment options (Review)","volume":"29","author":"Varra","year":"2024","journal-title":"Mol. Med. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"114253","DOI":"10.1016\/j.celrep.2024.114253","article-title":"Protective role for kidney TREM2high macrophages in obesity- and diabetes-induced kidney injury","volume":"43","author":"Subramanian","year":"2024","journal-title":"Cell Rep."},{"key":"ref_18","first-page":"69","article-title":"Adipokines and their role in chronic kidney disease","volume":"5","author":"Khazaei","year":"2016","journal-title":"J. Nephropharmacol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Stasi, A., Cosola, C., Caggiano, G., Cimmarusti, M.T., Palieri, R., Acquaviva, P.M., Rana, G., and Gesualdo, L. (2022). Obesity-Related Chronic Kidney Disease: Principal Mechanisms and New Approaches in Nutritional Management. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.925619"},{"key":"ref_20","first-page":"175","article-title":"Leptin and renal fibrosis","volume":"Volume 151","author":"Wolf","year":"2006","journal-title":"Obesity and the Kidney"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.mad.2019.01.004","article-title":"Resistin: A reappraisal","volume":"178","author":"Acquarone","year":"2019","journal-title":"Mech. Ageing Dev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1038\/sj.ki.5000089","article-title":"Elevated resistin levels in chronic kidney disease are associated with decreased glomerular filtration rate and inflammation, but not with insulin resistance","volume":"69","author":"Axelsson","year":"2006","journal-title":"Kidney Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"10840","DOI":"10.12998\/wjcc.v10.i30.10840","article-title":"Role of visfatin in obesity-induced insulin resistance","volume":"10","author":"Mohamed","year":"2022","journal-title":"World J. Clin. Cases"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/nri2921","article-title":"Adipokines in inflammation and metabolic disease","volume":"11","author":"Ouchi","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Coimbra, S., Rocha, S., Valente, M.J., Catarino, C., Bronze-da-Rocha, E., Belo, L., and Santos-Silva, A. (2022). New Insights into Adiponectin and Leptin Roles in Chronic Kidney Disease. Biomedicines, 10.","DOI":"10.3390\/biomedicines10102642"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1038\/nrneph.2017.107","article-title":"Mitochondrial energetics in the kidney","volume":"13","author":"Bhargava","year":"2017","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1159\/000083477","article-title":"Cellular oxidative processes in relation to renal disease","volume":"25","author":"Wardle","year":"2005","journal-title":"Am. J. Nephrol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12986-015-0044-z","article-title":"Mitochondria: A new therapeutic target in chronic kidney disease","volume":"12","author":"Granata","year":"2015","journal-title":"Nutr. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Zbrze\u017aniak-Suszczewicz, J., Winiarska, A., Perkowska-Ptasi\u0144ska, A., and Stomp\u00f3r, T. (2025). Obesity-Related Glomerulosclerosis-How Adiposity Damages the Kidneys. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26136247"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Njeim, R., Alkhansa, S., and Fornoni, A. (2023). Unraveling the Crosstalk between Lipids and NADPH Oxidases in Diabetic Kidney Disease. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15051360"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Corrales, P., Izquierdo-Lahuerta, A., and Medina-G\u00f3mez, G. (2018). Maintenance of Kidney Metabolic Homeostasis by PPAR Gamma. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19072063"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2715","DOI":"10.1681\/ASN.2007010089","article-title":"Role of altered renal lipid metabolism in the development of renal injury induced by a high-fat diet","volume":"18","author":"Kume","year":"2007","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1038\/s41581-020-0309-2","article-title":"Autophagy in kidney homeostasis and disease","volume":"16","author":"Tang","year":"2020","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"127110","DOI":"10.1016\/j.jhazmat.2021.127110","article-title":"Epigenetic regulator BRD4 is involved in cadmium-induced acute kidney injury via contributing to lysosomal dysfunction, autophagy blockade and oxidative stress","volume":"423","author":"Gong","year":"2022","journal-title":"J. Hazard. Mater."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Nakashima, A., Kato, K., Ohkido, I., and Yokoo, T. (2021). Role and Treatment of Insulin Resistance in Patients with Chronic Kidney Disease: A Review. Nutrients, 13.","DOI":"10.3390\/nu13124349"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2485927","DOI":"10.1080\/21623945.2025.2485927","article-title":"Disrupted adipokine secretion and inflammatory responses in human adipocyte hypertrophy","volume":"14","author":"Gao","year":"2025","journal-title":"Adipocyte"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Zhao, X., An, X., Yang, C., Sun, W., Ji, H., and Lian, F. (2023). The crucial role and mechanism of insulin resistance in metabolic disease. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1149239"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1080\/13813450802181047","article-title":"Insulin resistance associated to obesity: The link TNF-alpha","volume":"114","author":"Lorenzo","year":"2008","journal-title":"Arch. Physiol. Biochem."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1385\/ENDO:23:2-3:177","article-title":"The role of TNF-alpha in insulin resistance","volume":"23","author":"Borst","year":"2004","journal-title":"Endocrine"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kwon, H., and Pessin, J.E. (2013). Adipokines mediate inflammation and insulin resistance. Front. Endocrinol., 4.","DOI":"10.3389\/fendo.2013.00071"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e21216","DOI":"10.1096\/fj.202001147R","article-title":"Hyperleptinemia as a contributing factor for the impairment of glucose intolerance in obesity","volume":"35","author":"Pretz","year":"2021","journal-title":"FASEB J."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ksiazek, S.H., Hu, L., And\u00f2, S., Pirklbauer, M., S\u00e4emann, M.D., Ruotolo, C., Zaza, G., La Manna, G., De Nicola, L., and Mayer, G. (2024). Renin-Angiotensin-Aldosterone System: From History to Practice of a Secular Topic. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25074035"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1007\/s00424-024-02908-1","article-title":"The renin angiotensin aldosterone system","volume":"476","author":"Triebel","year":"2024","journal-title":"Pfl\u00fcgers Arch. Eur. J. Physiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s13679-023-00500-9","article-title":"The Fat Kidney","volume":"12","author":"Verde","year":"2023","journal-title":"Curr. Obes. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e13450","DOI":"10.1111\/obr.13450","article-title":"Obesity-related glomerulopathy: Current approaches and future perspectives","volume":"23","author":"Morales","year":"2022","journal-title":"Obes. Rev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.semnephrol.2012.12.002","article-title":"The role of the renin-angiotensin-aldosterone system in obesity-related renal diseases","volume":"33","author":"Wolf","year":"2013","journal-title":"Semin. Nephrol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1093\/cvr\/cvaa336","article-title":"Obesity, kidney dysfunction, and inflammation: Interactions in hypertension","volume":"117","author":"Hall","year":"2021","journal-title":"Cardiovasc. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1586\/17446651.1.2.255","article-title":"Obesity and the renin- angiotensin-aldosterone system","volume":"1","author":"Sharma","year":"2006","journal-title":"Expert. Rev. Endocrinol. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1159\/000528783","article-title":"Mineralocorticoid Receptor-Associated Mechanisms in Diabetic Kidney Disease and Clinical Significance of Mineralocorticoid Receptor Antagonists","volume":"54","author":"Mende","year":"2023","journal-title":"Am. J. Nephrol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Parasiliti-Caprino, M., Bollati, M., Merlo, F.D., Ghigo, E., Maccario, M., and Bo, S. (2022). Adipose Tissue Dysfunction in Obesity: Role of Mineralocorticoid Receptor. Nutrients, 14.","DOI":"10.3390\/nu14224735"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"F819","DOI":"10.1152\/ajprenal.00497.2016","article-title":"Primary proximal tubule hyperreabsorption and impaired tubular transport counterregulation determine glomerular hyperfiltration in diabetes: A modeling analysis","volume":"312","author":"Hallow","year":"2017","journal-title":"Am. J. Physiol. Renal Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.ekir.2017.01.007","article-title":"The Renal Pathology of Obesity","volume":"2","author":"Tsuboi","year":"2017","journal-title":"Kidney Int. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Rysz, J., Franczyk, B., \u0141awi\u0144ski, J., Olszewski, R., Cia\u0142kowska-Rysz, A., and Gluba-Brz\u00f3zka, A. (2021). The Impact of CKD on Uremic Toxins and Gut Microbiota. Toxins, 13.","DOI":"10.3390\/toxins13040252"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"M\u0142ynarska, E., Budny, E., Saar, M., Wojtanowska, E., Jankowska, J., Marciszuk, S., Mazur, M., Rysz, J., and Franczyk, B. (2024). Does the Composition of Gut Microbiota Affect Chronic Kidney Disease? Molecular Mechanisms Contributed to Decreasing Glomerular Filtration Rate. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms251910429"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Hu, X., Yu, C., He, Y., Zhu, S., Wang, S., Xu, Z., You, S., Jiao, Y., Liu, S., and Bao, H. (2024). Integrative metagenomic analysis reveals distinct gut microbial signatures related to obesity. BMC Microbiol., 24.","DOI":"10.1186\/s12866-024-03278-5"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Augustynowicz, G., Lasocka, M., Szyller, H.P., Dziedziak, M., Mytych, A., Braksator, J., and Pytrus, T. (2025). The Role of Gut Microbiota in the Development and Treatment of Obesity and Overweight: A Literature Review. J. Clin. Med., 14.","DOI":"10.3390\/jcm14144933"},{"key":"ref_57","first-page":"501624","article-title":"Taxonomic and functional characteristics of the gut microbiota in obesity: A systematic review","volume":"72","author":"Mela","year":"2025","journal-title":"Endocrinol. Diabetes Nutr. (Engl. Ed.)"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Pinart, M., D\u00f6tsch, A., Schlicht, K., Laudes, M., Bouwman, J., Forslund, S.K., Pischon, T., and Nimptsch, K. (2021). Gut Microbiome Composition in Obese and Non-Obese Persons: A Systematic Review and Meta-Analysis. Nutrients, 14.","DOI":"10.3390\/nu14010012"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1080\/00325481.2015.1098519","article-title":"Changes seen in gut bacteria content and distribution with obesity: Causation or association?","volume":"127","author":"Bell","year":"2015","journal-title":"Postgrad. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s11906-023-01263-3","article-title":"Gut Microbiota and Its Role in the Brain-Gut-Kidney Axis in Hypertension","volume":"25","author":"Vallianou","year":"2023","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1007\/s13679-024-00583-y","article-title":"The Kidney in Obesity: Current Evidence, Perspectives and Controversies","volume":"13","author":"Kounatidis","year":"2024","journal-title":"Curr. Obes. Rep."},{"key":"ref_62","first-page":"1130","article-title":"A Review of the Literature on Obesity-Related Chronic Kidney Disease: A Molecular Description of Gene Susceptibility to Polymorphisms, Noncoding RNAs, and Pathophysiology","volume":"21","author":"Yenanegy","year":"2025","journal-title":"Arch. Med. Sci."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e9086","DOI":"10.1371\/journal.pone.0009086","article-title":"Genetic Variation at Selected SNPs in the Leptin Gene and Association of Alleles with Markers of Kidney Disease in a Xhosa Population of South Africa","volume":"5","author":"Okpechi","year":"2010","journal-title":"PLoS ONE"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1093\/ndt\/gfr418","article-title":"The FTO gene polymorphism is associated with end-stage renal disease: Two large independent case-control studies in a general population","volume":"27","author":"Hubacek","year":"2012","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Lin, J., Hu, F.B., Qi, L., and Curhan, G.C. (2009). Genetic polymorphisms of angiotensin-2 type 1 receptor and angioten-sinogen and risk of renal dysfunction and coronary heart disease in type 2 diabetes mellitus. BMC Nephrol., 10.","DOI":"10.1186\/1471-2369-10-9"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1681\/ASN.2020050679","article-title":"Conventional and Genetic Evidence on the Association between Adiposity and CKD","volume":"32","author":"Zhu","year":"2021","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/clinchem\/hvab249","article-title":"Obesity and Kidney Function: A Two-Sample Mendelian Randomization Study","volume":"68","author":"Kjaergaard","year":"2022","journal-title":"Clin. Chem."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Carullo, N., Zicarelli, M., Michael, A., Faga, T., Battaglia, Y., Pisani, A., Perticone, M., Costa, D., Ielapi, N., and Coppolino, G. (2023). Childhood Obesity: Insight into Kidney Involvement. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms242417400"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.4081\/pr.2011.e27","article-title":"Impact of obesity on childhood kidney","volume":"3","author":"Kaneko","year":"2011","journal-title":"Pediatr. Rep."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1007\/s13679-023-00522-3","article-title":"Kidney Considerations in Pediatric Obesity","volume":"12","author":"Sawyer","year":"2023","journal-title":"Curr. Obes. Rep."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Le\u00f3n-Rom\u00e1n, J., L\u00f3pez-Mart\u00ednez, M., Esteves, A., Ciudin, A., N\u00fa\u00f1ez-Delgado, S., \u00c1lvarez, T., Lecube, A., Ri-co-Fontalvo, J., and Soler, M.J. (2025). Obesity-Related Kidney Disease: A Growing Threat to Renal Health. Int. J. Mol. Sci., 26.","DOI":"10.20944\/preprints202505.1929.v1"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1159\/000531379","article-title":"Chronic Kidney Disease and Obesity","volume":"147","author":"Hojs","year":"2023","journal-title":"Nephron"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Avgoustou, E., Tzivaki, I., Diamantopoulou, G., Zachariadou, T., Avramidou, D., Dalopoulos, V., and Skourtis, A. (2025). Obesity-Related Chronic Kidney Disease: From Diagnosis to Treatment. Diagnostics, 15.","DOI":"10.3390\/diagnostics15020169"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1681\/ASN.2005111241","article-title":"Increasing Body Mass Index and Obesity in the Incident ESRD Population","volume":"17","author":"Kramer","year":"2006","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1177\/08968608251360297","article-title":"Challenges and opportunities in managing individuals with obesity on peritoneal dialysis","volume":"45","author":"Abra","year":"2025","journal-title":"Perit. Dial. Int."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.kint.2025.06.013","article-title":"S.E.N., SLANH, and SEEDO consensus report on obesity-related kidney disease: Proposal for a new classification","volume":"108","author":"Ciudin","year":"2025","journal-title":"Kidney Int."},{"key":"ref_77","first-page":"24","article-title":"The role of obesity on chronic kidney disease development, progression, and cardiovascular complications","volume":"2","author":"Than","year":"2020","journal-title":"Adv. Biomark. Sci. Technol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1111\/sdi.12876","article-title":"Impact of obesity on dialysis and transplant and its management","volume":"33","author":"Diwan","year":"2020","journal-title":"Semin. Dial."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.semnephrol.2021.03.013","article-title":"Obesity, Chronic Kidney Disease, and Kidney Transplantation: An Evolving Relationship","volume":"41","author":"Azhar","year":"2021","journal-title":"Semin. Nephrol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1038\/s41574-019-0176-8","article-title":"Obesity: Global epidemiology and pathogenesis","volume":"15","year":"2019","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1093\/ndt\/gfw075","article-title":"Obesity and the risk of cardiovascular and all-cause mortality in chronic kidney disease: A systematic review and meta-analysis","volume":"32","author":"Ladhani","year":"2017","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejim.2016.03.016","article-title":"Obese and diabetic patients with end-stage renal disease: Peritoneal dialysis or hemodialysis?","volume":"32","author":"Ekart","year":"2016","journal-title":"Eur. J. Intern. Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.ekir.2017.01.009","article-title":"The Obesity Paradox in Kidney Disease: How to Reconcile it with Obesity Management","volume":"2","author":"Rhee","year":"2017","journal-title":"Kidney Int. Rep."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.pcad.2013.10.005","article-title":"Obesity Paradox in End-Stage Kidney Disease Patients","volume":"56","author":"Park","year":"2014","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Chan, G.C.-K., N. G., J.K.-C., Chow, K.-M., Kwong, V.W.-K., Pang, W.-F., Cheng, P.M.-S., Law, M.-C., Leung, C.-B., L. I., P.K., and Szeto, C.C. (2020). Interaction between central obesity and frailty on the clinical outcome of peritoneal dialysis patients. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241242"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s11255-014-0653-x","article-title":"Body mass index and mortality in patients on maintenance hemodialysis: A meta-analysis","volume":"46","author":"Li","year":"2014","journal-title":"Int. Urol. Nephrol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"505","DOI":"10.2147\/DMSO.S150914","article-title":"Visceral-to-subcutaneous fat ratio as a predictor of the multiple metabolic risk factors for subjects with normal waist circumference in Korea","volume":"10","author":"Oh","year":"2017","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Liu, J., Zeng, X., Hong, H.G., Li, Y., and Fu, P. (2017). The association between body mass index and mortality among Asian peritoneal dialysis patients: A meta-analysis. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0172369"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1053\/j.ajkd.2017.09.010","article-title":"Impact of Obesity on Modality Longevity, Residual Kidney Function, Peritonitis, and Survival Among Incident Peritoneal Dialysis Patients","volume":"71","author":"Obi","year":"2018","journal-title":"Am. J. Kidney Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1097\/MNH.0000000000001124","article-title":"Management of peritoneal dialysis in patients with obesity","volume":"35","author":"Bansal","year":"2026","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1111\/j.1525-139X.2008.00434.x","article-title":"Obesity as a predictor of vascular access outcomes: Analysis of the USRDS DMMS Wave II study","volume":"21","author":"Chan","year":"2008","journal-title":"Semin. Dial."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1177\/1129729818762994","article-title":"One-stage operation for superficialization of native radio-cephalic fistula in obese patients","volume":"20","author":"Okawa","year":"2019","journal-title":"J. Vasc. Access"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.avsg.2016.03.014","article-title":"Obesity Increases the Risk of Primary Nonfunction and Early Access Loss, and Decreases Overall Patency in Patients Who Underwent Hemodialysis Reliable Outflow Device Placement","volume":"36","author":"Naffouje","year":"2016","journal-title":"Ann. Vasc. Surg."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/j.1525-139X.2011.01017.x","article-title":"Treating the obese dialysis patient: Challenges and paradoxes","volume":"25","author":"Schmidt","year":"2012","journal-title":"Semin. Dial."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1159\/000479118","article-title":"Challenges Associated with Managing End-Stage Renal Disease in Extremely Morbid Obese Patients: Case Series and Literature Review","volume":"137","author":"Turgut","year":"2017","journal-title":"Nephron"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.annemergmed.2007.08.014","article-title":"Emergency Departments Shoulder Challenges of Providing Care, Preserving Dignity for the \u201cSuper Obese\u201d","volume":"50","author":"Berger","year":"2007","journal-title":"Ann. Emerg. Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"2894","DOI":"10.1097\/01.ASN.0000091587.55159.5F","article-title":"Obesity is associated with worse peritoneal dialysis outcomes in the Australia and New Zealand patient populations","volume":"14","author":"McDonald","year":"2003","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1038\/ki.2009.94","article-title":"The outcomes of continuous ambulatory and automated peritoneal dialysis are similar","volume":"76","author":"Mehrotra","year":"2009","journal-title":"Kidney Int."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1007\/s00464-017-5852-y","article-title":"Peritoneal dialysis catheter function and survival are not adversely affected by obesity regardless of the operative technique used","volume":"32","author":"Krezalek","year":"2018","journal-title":"Surg. Endosc."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1097\/TP.0b013e31819e3f14","article-title":"Bariatric surgery among kidney transplant candidates and recipients: Analysis of the United States Renal Data System and literature review","volume":"87","author":"Modanlou","year":"2009","journal-title":"Transplantation"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"399","DOI":"10.3747\/pdi.2013.00056","article-title":"Effect of body mass index on outcomes of peritoneal dialysis patients in India","volume":"34","author":"Prasad","year":"2014","journal-title":"Perit. Dial. Int."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1093\/ckj\/sfaa055","article-title":"Impact of obesity on the evolution of outcomes in peritoneal dialysis patients","volume":"14","author":"Quero","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"290","DOI":"10.3747\/pdi.2016.00053","article-title":"The 24-Month Changes in Body Fat Mass and Adipokines in Patients Starting Peritoneal Dialysis","volume":"37","author":"Choi","year":"2017","journal-title":"Perit. Dial. Int."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"124","DOI":"10.4103\/ijn.IJN_341_20","article-title":"Peritoneal Dialysis Catheter Insertion by Nephrologist Using Minilaparotomy: Do Survival and Complications Vary in Obese?","volume":"31","author":"Dogra","year":"2021","journal-title":"Indian. J. Nephrol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.34067\/KID.0004722020","article-title":"A Model To Estimate Glucose Absorption in Peritoneal Dialysis: A Pilot Study","volume":"1","author":"Kotla","year":"2020","journal-title":"Kidney360"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"3631","DOI":"10.1093\/ndt\/gfs131","article-title":"Relationship of body size and initial dialysis modality on subsequent transplantation, mortality and weight gain of ESRD patients","volume":"27","author":"Lievense","year":"2012","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1053\/j.ajkd.2022.07.004","article-title":"Peritoneal Dialysis Prescription and Adequacy in Clinical Practice: Core Curriculum 2023","volume":"81","author":"Auguste","year":"2023","journal-title":"Am. J. Kidney Dis."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1093\/ajcn\/80.2.324","article-title":"Association of body size with outcomes among patients beginning dialysis","volume":"80","author":"Johansen","year":"2004","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_109","first-page":"441","article-title":"Kidney Transplant and Cardiovascular-Kidney-Metabolic Health","volume":"43","author":"Jittirat","year":"2025","journal-title":"Cardiol. Clin."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1097\/TP.0000000000004564","article-title":"Obesity and Kidney Transplantation-How to Evaluate, What to Do, and Outcomes","volume":"107","author":"Bencini","year":"2023","journal-title":"Transplantation"},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Lafranca, J.A., IJermans, J.N.M., Betjes, M.G.H., and Dor, F.J.M.F. (2015). Body mass index and outcome in renal transplant recipients: A systematic review and meta-analysis. BMC Med., 13.","DOI":"10.1186\/s12916-015-0340-5"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1159\/000367812","article-title":"Body mass index and mortality in kidney transplant recipients: A systematic review and meta-analysis","volume":"40","author":"Ahmadi","year":"2014","journal-title":"Am. J. Nephrol."},{"key":"ref_113","first-page":"121","article-title":"Consequences of Recipient Obesity on Postoperative Outcomes in a Renal Transplant: A Systematic Review and Meta-Analysis","volume":"14","author":"Sood","year":"2016","journal-title":"Exp. Clin. Transplant."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1016\/j.transproceed.2018.02.075","article-title":"Association of Body Mass Index and the Risk of New-Onset Diabetes After Kidney Transplantation: A Meta-analysis","volume":"50","author":"Chang","year":"2018","journal-title":"Transplant. Proc."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/TP.0000000000000028","article-title":"Effects of obesity on kidney transplantation outcomes: A systematic review and meta-analysis","volume":"98","author":"Nicoletto","year":"2014","journal-title":"Transplantation"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"2378","DOI":"10.1111\/ajt.13363","article-title":"Kidney Transplantation Significantly Improves Patient and Graft Survival Irrespective of BMI: A Cohort Study","volume":"15","author":"Krishnan","year":"2015","journal-title":"Am. J. Transplant."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s40620-019-00654-7","article-title":"UK renal transplant outcomes in low and high BMI recipients: The need for a national policy","volume":"33","author":"Kostakis","year":"2020","journal-title":"J. Nephrol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1111\/ajt.12331","article-title":"The survival benefit of kidney transplantation in obese patients","volume":"13","author":"Gill","year":"2013","journal-title":"Am. J. Transplant."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"2951","DOI":"10.1007\/s11695-017-2722-6","article-title":"Bariatric Surgery as a Bridge to Renal Transplantation in Patients with End-Stage Renal Disease","volume":"27","author":"Fakhry","year":"2017","journal-title":"Obes. Surg."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"sfae377","DOI":"10.1093\/ckj\/sfae377","article-title":"The evaluation of kidney transplant candidates prior to waitlisting: A scoping review","volume":"18","author":"Boerstra","year":"2025","journal-title":"Clin. Kidney J."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1097\/TP.0000000000002046","article-title":"Variation in Practice Patterns for Listing Patients for Renal Transplantation in the United Kingdom: A National Survey","volume":"102","author":"Pruthi","year":"2018","journal-title":"Transplantation"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1093\/ndt\/gfy391","article-title":"Standard work-up of the low-risk kidney transplant candidate: A European expert survey of the ERA-EDTA Developing Education Science and Care for Renal Transplantation in European States Working Group","volume":"34","author":"Maggiore","year":"2019","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"i1","DOI":"10.1093\/ndt\/gfab310","article-title":"Management of obesity in kidney transplant candidates and recipients: A clinical practice guideline by the DESCARTES Working Group of ERA","volume":"37","author":"Oniscu","year":"2021","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1097\/TP.0000000000003136","article-title":"KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation","volume":"104","author":"Chadban","year":"2020","journal-title":"Transplantation"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1053\/j.ackd.2021.09.009","article-title":"Obesity Management in Kidney Transplant Candidates: Current Paradigms and Gaps in Knowledge","volume":"28","author":"Lee","year":"2021","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1681\/ASN.0000000512","article-title":"ASN Kidney Health Guidance on the Management of Obesity in Persons Living with Kidney Diseases","volume":"35","author":"Ikizler","year":"2024","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"105","author":"Stevens","year":"2024","journal-title":"Kidney Int."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/j.ekir.2025.03.022","article-title":"New Obesity Guidelines and Implications for CKD","volume":"10","author":"Drueke","year":"2025","journal-title":"Kidney Int. Rep."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.mayocp.2024.01.017","article-title":"Weight Loss Surgery Increases Kidney Transplant Rates in Patients with Renal Failure and Obesity","volume":"99","author":"Kukla","year":"2024","journal-title":"Mayo Clin. Proc."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1177\/00031348241275714","article-title":"Medical and Surgical Weight Loss as a Pathway to Renal Transplant Listing","volume":"91","author":"Samuels","year":"2025","journal-title":"Am. Surg."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.34067\/KID.0000000813","article-title":"Medical Therapy versus Bariatric Surgery in Kidney Transplant Candidates","volume":"6","author":"Bzoma","year":"2025","journal-title":"Kidney360"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.4239\/wjd.v12.i9.1563","article-title":"Obesity and bariatric surgery in kidney transplantation: A clinical review","volume":"12","author":"Veroux","year":"2021","journal-title":"World J. Diabetes"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.amjsurg.2020.04.041","article-title":"Bariatric surgery to achieve transplant in end-stage organ disease patients: A systematic review and meta-analysis","volume":"220","author":"Orandi","year":"2020","journal-title":"Am. J. Surg."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1007\/s11605-019-04225-w","article-title":"Sleeve Gastrectomy Compared with Gastric Bypass for Morbidly Obese Patients with End Stage Renal Disease: A Decision Analysis","volume":"24","author":"Choudhury","year":"2020","journal-title":"J. Gastrointest. Surg."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"116475","DOI":"10.1016\/j.amjsurg.2025.116475","article-title":"Sleeve gastrectomy versus dual GLP-1\/GIP receptor agonist to improve access to kidney transplantation in patients with end-stage renal disease and obesity: A decision analysis","volume":"250","author":"Rouhi","year":"2025","journal-title":"Am. J. Surg."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/TP.0000000000001249","article-title":"Single Center Experience With Robotic Kidney Transplantation for Recipients With BMI of 40 kg\/m2 Or Greater: A Comparison With the UNOS Registry","volume":"101","author":"Tzvetanov","year":"2017","journal-title":"Transplantation"},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1111\/ajt.15626","article-title":"Robotic kidney transplantation in the obese patient: 10-year experience from a single center","volume":"20","author":"Tzvetanov","year":"2020","journal-title":"Am. J. Transplant."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1111\/ajt.16322","article-title":"Simultaneous robotic kidney transplantation and bariatric surgery for morbidly obese patients with end-stage renal failure","volume":"21","author":"Spaggiari","year":"2021","journal-title":"Am. J. Transplant."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1089\/dia.2024.0122","article-title":"Contemporary Management of Obesity: A Comparison of Bariatric Metabolic Surgery and Novel Incretin Mimetic Drugs","volume":"26","author":"Singh","year":"2024","journal-title":"Diabetes Technol. Ther."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.numecd.2023.03.023","article-title":"Glucagon-like peptide 1 receptor agonists in end-staged kidney disease and kidney transplantation: A narrative review","volume":"33","author":"Clemens","year":"2023","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"e70344","DOI":"10.1111\/ctr.70344","article-title":"Bridging the Gap to Waitlist Activation: Semaglutide\u2019s Weight Loss Efficacy and Safety in Patients with Obesity on Dialysis Seeking Kidney Transplantation","volume":"39","author":"Wade","year":"2025","journal-title":"Clin. Transplant."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"5931","DOI":"10.1111\/dom.15967","article-title":"Semaglutide in patients with kidney failure and obesity undergoing dialysis and wishing to be transplanted: A prospective, observational, open-label study","volume":"26","author":"Vanek","year":"2024","journal-title":"Diabetes Obes. Metab."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1093\/ndt\/gfab164","article-title":"Pre-kidney transplant unintentional weight loss leads to worse post-kidney transplant outcomes","volume":"36","author":"Harhay","year":"2021","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1053\/j.jrn.2018.03.001","article-title":"A Randomized Controlled Trial of an Intensive Nutrition Intervention Versus Standard Nutrition Care to Avoid Excess Weight Gain After Kidney Transplantation: The INTENT Trial","volume":"28","author":"Henggeler","year":"2018","journal-title":"J. Ren. Nutr."},{"key":"ref_145","doi-asserted-by":"crossref","unstructured":"Barchfeld, D.C., Vagi, R., L\u00fcdtke, K., Schieffer, E., G\u00fcler, F., Einecke, G., J\u00e4ger, B., de Zwaan, M., and N\u00f6hre, M. (2023). Cognitive-behavioral and dietary weight loss intervention in adult kidney transplant recipients with overweight and obesity: Results of a pilot RCT study (Adi-KTx). Front. Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1071705"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1056\/NEJMoa2107519","article-title":"Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes","volume":"385","author":"Davies","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_147","first-page":"100343","article-title":"Safety and efficacy of semaglutide in post kidney transplant patients with type 2 diabetes or Post-Transplant diabetes","volume":"36","author":"Mahzari","year":"2024","journal-title":"J. Clin. Transl. Endocrinol."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1093\/ndt\/gfaf069","article-title":"How to individualize renoprotective therapy in obese patients with chronic kidney disease: A commentary by the Diabesity Working Group of the ERA","volume":"40","author":"Morales","year":"2025","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_149","doi-asserted-by":"crossref","unstructured":"Valencia-Morales, N.D., Rodr\u00edguez-Cubillo, B., Loayza-L\u00f3pez, R.K., Moreno de la Higuera, M.\u00c1., and S\u00e1nchez-Fructuoso, A.I. (2023). Novel Drugs for the Management of Diabetes Kidney Transplant Patients: A Literature Review. Life, 13.","DOI":"10.3390\/life13061265"},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.transproceed.2017.02.032","article-title":"Bariatric Surgery to Target Obesity in the Renal Transplant Population: Preliminary Experience in a Single Center","volume":"49","author":"Gazzetta","year":"2017","journal-title":"Transplant. Proc."},{"key":"ref_151","doi-asserted-by":"crossref","unstructured":"Polychronopoulou, E., Bourdon, F., and Teta, D. (2024). SGLT2 inhibitors in diabetic and non-diabetic kidney transplant recipients: Current knowledge and expectations. Front. Nephrol., 4.","DOI":"10.3389\/fneph.2024.1332397"},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"101627","DOI":"10.1016\/j.diabet.2025.101627","article-title":"Safety of sodium-glucose cotransporter 2 inhibitors in kidney transplant recipients with diabetes mellitus","volume":"51","author":"Polansky","year":"2025","journal-title":"Diabetes Metab."},{"key":"ref_153","doi-asserted-by":"crossref","unstructured":"Chewcharat, A., Prasitlumkum, N., Thongprayoon, C., Bathini, T., Medaura, J., Vallabhajosyula, S., and Cheungpasitporn, W. (2020). Efficacy and Safety of SGLT-2 Inhibitors for Treatment of Diabetes Mellitus among Kidney Transplant Patients: A Systematic Review and Meta-Analysis. Med. Sci., 8.","DOI":"10.3390\/medsci8040047"},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"10043","DOI":"10.1038\/s41467-024-54171-8","article-title":"The outcomes of SGLT-2 inhibitor utilization in diabetic kidney transplant recipients","volume":"15","author":"Sheu","year":"2024","journal-title":"Nat. Commun."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/211\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T12:06:43Z","timestamp":1768910803000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":154,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["medicina62010211"],"URL":"https:\/\/doi.org\/10.3390\/medicina62010211","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]}}}