UNASSIGNED: The @entity28 epidemic has not spared the population with @entity177 . @entity28 impacts prognosis after kidney transplantation, as markers of @entity28 are associated with worse outcomes (e.g. delayed graft function, graft failure, @entity65 , costs) compared with ideal values in most studies. @entity28 is also potentially modifiable. Kidney transplants are a scarce resource and the obligation to steward organs to good outcomes is inherent in transplant practice. Thus, it is appropriate to establish pretransplant @entity353 targets and engage @entity28 @entity1 seeking transplantation in shared responsibility agreements to strive to reach goals. Nonetheless, important caveats may qualify the stringency of pretransplant @entity353 requirements. @entity28 @entity1 (who are otherwise healthy enough for transplant) may benefit from transplantation compared with long-term dialysis based on metrics such as improved long-term survival and lower cardiac risk. When optimal @entity353 is difficult to achieve, factors in a given program's ability to extend the limits of @entity28 acceptable for safe and effective transplantation include expertise (e.g. surgical approaches and clinical management), tolerance for risk based on overall performance and tolerance for costs. More research is needed, including formal cost-effectiveness studies of transplantation in @entity28 @entity1 to determine if payers (e.g. Medicare) and society should be compensating programs for clinical and financial risks, and whether the risks are worth taking. To generate evidence to better guide management, prospective evaluations of the impact of intentional @entity353 strategies in this population, including studies of dietary change, monitored exercise and bariatric surgery, are also urgently needed.

Pro: Pretransplant XXXX : yes.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity353 :: ('MESH:D015431', 'Disease') :: ['weight loss'] @entity28 :: ('MESH:D009765', 'Disease') :: ['Obesity', 'Obese', 'obese', 'obesity'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular disease']
@entity353 :: (MESH:D015431,Disease) :: ['weight loss']
