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Kidney Week

Abstract: PO1736

Understanding Obesity Management in CKD Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Chiu, Michael, London Health Sciences Centre, London, Ontario, Canada
  • Koyle, Kathy, London Health Sciences Centre, London, Ontario, Canada
  • Jain, Arsh, London Health Sciences Centre, London, Ontario, Canada
Background

Obesity is a global epidemic that is directly and indirectly linked to progression of chronic kidney disease (CKD). Nephrologists’ attitude towards obesity management is not understood.

Methods

We surveyed 14 nephrologists practicing in an academic centre in London, Ontario, Canada to investigate their perception and management of obesity. Then we performed a retrospective chart review of patients in a CKD clinic with obesity (BMI >30kg/m2). Ten follow-up visits were randomly selected for each nephrologist between Jan-Dec 2019. Each chart was assessed for documentation of obesity and a management plan such as lifestyle counselling, pharmacologic intervention, or specialist referral.

Results

There were 13 responses (93%). Responses from a 5-point Likert scale, agree and strongly agree, have been combined. All nephrologists agreed that obesity negatively impacts CKD patients. 92% reported that discussing obesity evokes a negative response and 39% thought patients want to discuss obesity. Interestingly, 0% of nephrologists thought patients know that obesity has effective treatments. 85% of nephrologists talked to their patients about obesity, but 0% felt that they had time to treat it. With regards to management, 54% of nephrologists were comfortable with non-pharmacologic treatment, but only one was comfortable with pharmacologic treatments. 85% of respondents felt that patients should be referred to a specialist. A total of 140 charts were reviewed with a mean age 66 years, weight 105 kg, and BMI 37 kg/m2. Only one chart had obesity as a clinical issue and documented a weight loss discussion using non-pharmacologic strategies.

Conclusion

Our results suggest that obesity is rarely managed despite nephrologists’ desire to treat it. This care gap can be addressed using robust Quality Improvement principles. Our centre will improve obesity management by developing a clinical handbook for nephrologists on how to efficiently address obesity with patients as well as a partnership and streamlined referral process to an obesity specialist.

Funding

  • Clinical Revenue Support