title: Paediatric obesity and renal transplantation: current challenges and solutions.
abstract: The increased incidence of obesity in the paediatric population poses significant challenges to renal transplantation. Whilst the body mass index appears to be widely used as a measure of obesity in adults, there are no standardised definitions in the paediatric population, making comparative analyses difficult. In the paediatric transplant population, obesity is associated with an increased incidence of surgical complications, diabetes, hyperlipidaemia and cardiovascular morbidity, leading to diminished graft function and impacting patient and graft survival. Management of obesity in renal transplantation requires multiple interventions starting with life-style and behavioural modification combined with medical and possibly surgical therapies, representing a unique challenge in the childhood setting. In this review we discuss the current challenges of obesity and potential solutions in the setting of paediatric transplantation.
authors.affiliation: Transplant Unit, The Royal Infirmary of Edinburgh, Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK.
authors.forename: John D
authors.initials: JD
authors.lastname: Terrace
authors.affiliation: Transplant Unit, The Royal Infirmary of Edinburgh, Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK. gabriel.oniscu@ed.ac.uk.
authors.forename: Gabriel C
authors.initials: GC
authors.lastname: Oniscu
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D006085:Graft Survival; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D063766:Pediatric Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D015995:Prevalence; D055031:Primary Graft Dysfunction / Q000453:epidemiology / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Graft function; Management; Obesity; Paediatric; Renal transplantation; Survival