Treating the Obese Dialysis Patient: Challenges and Paradoxes

Seminars in Dialysis

Volumn 25, Issue 3, 2012, Pages 311-319

  Celebi Onder, Songul ^a   Schmidt, Rebecca J ^a   Holley, Jean L ^b  

^a WEST VIRGINIA UNIVERSITY HOSPITALS   (United States)

^b UNIVERSITY OF ILLINOIS AT URBANA CHAMPAIGN   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CHRONIC KIDNEY FAILURE; HEALTH; HUMAN; INCIDENCE; OBESITY; RENAL REPLACEMENT THERAPY; REVIEW; WEIGHT REDUCTION;

HUMANS; INCIDENCE; KIDNEY FAILURE, CHRONIC; OBESITY; RENAL REPLACEMENT THERAPY; WEIGHT LOSS; WORLD HEALTH;

EID: 84861229777     PISSN: 08940959     EISSN: 1525139X     Source Type: Journal    
DOI: 10.1111/j.1525-139X.2011.01017.x     Document Type: Review

References (108)

1. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP: The spread of the obesity epidemic in the United States, 1991-1998. JAMA 282:1519-1522, 1999
2. Flegal KM, Carroll MD, Ogden CL, Johnson CL: Prevalence and trends in obesity among US adults, 1999-2000. JAMA 288:1723-1727, 2002
3. Kramer HJ, Saranathan A, Luke A, Durazo-Arvizu RA, Guichan C, Hou S, Cooper R: Increasing body mass index and obesity in the incident ESRD population. J Am Soc Nephrol 17:1453-1459, 2006
4. Reaven G, Abbasi F, McLaughlin T: Obesity, insulin resistance, and cardiovascular disease. Recent Prog Horm Res 59:207-223, 2004
5. Plumb J, Brawer R, Brisbon N: The interplay of obesity and asthma. Curr Allergy Asthma Rep 7:385-389, 2007
6. Garstang SV, Stitik TP: Osteoarthritis: epidemiology, risk factors, and pathophysiology. Am J Phys Med Rehab 85:S2-S11, 2006
7. Thum T, Anker SD: Obesity and risk of myocardial infarction: the INTERHEART study. Lancet 367:1051-1052, 2006
8. Romero-Corral A, Montori VM, Somers VK, Korinek J, Thomas RJ, Allison TG, Mookadam F, Lopez-Jimenez F: Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet 368:666-678, 2006
9. Abdulla J, Køber L, Abildstrøm SZ, Christensen E, James WP, Torp-Pedersen C: Impact of obesity as a mortality predictor in high-risk patients with myocardial infarction or chronic heart failure: a pooled analysis of five registries. Eur Heart J 29:594-601, 2008
10. Soubassi LP, Papadakis ED, Theodoropoulos IK, Poulos GD, Chaniotis D, Tsapakidis IP, Zerefos SN, Douli M, Chiras TCh, Kouvelis A, Daglas GK, Soubassi SP, Valis DN, Zerefos NS: Incidence and risk factors of coronary artery disease in patients on chronic hemodialysis. Int J Artif Organs 30:253-257, 2007
11. Iseki K, Ikemiya Y, Kinjo K, Inoue T, Iseki C, Takishita S: Body mass index and the risk of development of end-stage renal disease in a screened cohort. Kidney Int 65(5):1870-1876, 2004
12. Iseki K: Body mass index and the risk of chronic renal failure: the Asian experience. Contrib Nephrol 151:42-56, 2006
13. Praga M, Morales E: Obesity, proteinuria and progression of renal disease. Curr Opin Nephrol Hypertens 15:481-486, 2006
14. Nguyen S, Hsu CY: Excess weight as a risk factor for kidney failure. Curr Opin Nephrol Hypertens 16:71-76, 2007
15. Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS: Body mass index and risk for end-stage renal disease. Ann Intern Med 144:21-28, 2006
16. Degoulet P, Legrain M, Réach I, Aimé F, Devriés C, Rojas P, Jacobs C: Mortality risk factors in patients treated by chronic hemodialysis. Report of the Diaphane collaborative study. Nephron 31:103-110, 1982
17. Leavey SF, Strawderman RL, Jones CA, Port FK, Held PJ: Simple nutritional indicators as independent predictors of mortality in hemodialysis patients. Am J Kidney Dis 31:997-1006, 1998
18. Fleischmann E, Teal N, Dudley J, May W, Bower JD, Salahudeen AK: Influence of excess weight on mortality and hospital stay in 1346 hemodialysis patients. Kidney Int 55:1560-1567, 1999
19. Kopple JD, Zhu X, Lew NL, Lowrie EG: Body weight-for-height relationships predict mortality in maintenance hemodialysis patients. Kidney Int 56:1136-1148, 1999
20. Wolfe RA, Ashby VB, Daugirdas JT, Agodoa LY, Jones CA, Port FK: Body size, dose of hemodialysis, and mortality. Am J Kidney Dis 35:80-88, 2000
21. Leavey SF, McCullough K, Hecking E, Goodkin D, Port FK, Young EW: Body mass index and mortality in 'healthier' as compared with 'sicker' hemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 16:2386-2394, 2001
22. Port FK, Ashby VB, Dhingra RK, Roys EC, Wolfe RA: Dialysis dose and body mass index are strongly associated with survival in hemodialysis patients. J Am Soc Nephrol 13:1061-1066, 2002
23. Lowrie EG, Li Z, Ofsthun N, Lazarus JM: Body size, dialysis dose and death risk relationships among hemodialysis patients. Kidney Int 62:1891-1897, 2002
24. Glanton CW, Hypolite IO, Hshieh PB, Agodoa LY, Yuan CM, Abbott KC: Factors associated with improved short term survival in obese end stage renal disease patients. Ann Epidemiol 13:136-143, 2003
25. Johansen KL, Young B, Kaysen GA, Chertow GM: Association of body size with outcomes among patients beginning dialysis. Am J Clin Nutr 80:324-332, 2004
26. Kalantar-Zadeh K, Kopple JD, Kilpatrick RD, McAllister CJ, Shinaberger CS, Gjertson DW, Greenland S: Association of morbid obesity and weight change over time with cardiovascular survival in hemodialysis population. Am J Kidney Dis 46(3):489-500, 2005
27. Johnson DW, Herzig KA, Purdie DM, Chang W, Brown AM, Rigby RJ, Campbell SB, Nicol DL, Hawley CM: Is obesity a favorable prognostic factor in peritoneal dialysis patients? Perit Dial Int 20(6):715-721, 2000
28. McDonald SP, Collins JF, Johnson DW: Obesity is associated with worse peritoneal dialysis outcomes in the Australia and New Zealand patient populations. J Am Soc Nephrol 14:2894-2901, 2003
29. Meier-Kriesche HU, Vaghela M, Thambuganipalle R, Friedman G, Jacobs M, Kaplan B: The effect of body mass index on long-term renal allograft survival. Transplantation 68:1294-1297, 1999
30. Meier-Kriesche H-U, Arndorfer JA, Kaplan B: The impact of body mass index on renal transplant outcomes: a significant independent risk factor for graft failure and patient death. Transplantation 73:70-74, 2002
31. WHO: Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. WHO Technical Report Series 894. Geneva: World Health Organization, 2000
32. Heiat A, Vaccarino V, Krumholz HM: An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Arch Intern Med 161:1194-1203, 2001
33. Sergi G, Perissinotto E, Pisent C, Buja A, Maggi S, Coin A, Grigoletto F, Enzi G, ILSA Working Group: An adequate threshold for body mass index to detect underweight condition in elderly persons: the Italian Longitudinal Study on Aging (ILSA). J Gerontol A Biol Sci Med Sci 60:866-871, 2005
34. Schooling CM, Lam TH, Li ZB, Ho SY, Chan WM, Ho KS, Tham MK, Cowling BJ, Leung GM: Obesity, physical activity, and mortality in a prospective Chinese elderly cohort. Arch Intern Med 166:1498-1504, 2006
35. Janssen I, Mark AE: Elevated body mass index and mortality risk in the elderly. Obes Rev 1:41-59, 2007
36. Sarkar SR, Kuhlmann MK, Kotanko P, Zhu F, Heymsfield SB, Wang J, Meisels IS, Gotch FA, Kaysen GA, Levin NW: Metabolic consequences of body size and body composition in hemodialysis patients. Kidney Int 70:1832-1839, 2006
37. Cordeiro AC, Qureshi AR, Stenvinkel P, Heimbürger O, Axelsson J, Bárány P, Lindholm B, Carrero JJ: Abdominal fat deposition is associated with increased inflammation, protein-energy wasting and worse outcome in patients undergoing haemodialysis. Nephrol Dial Transplant 25(2):562-568, 2010
38. Araújo IC, Kamimura MA, Draibe SA, Canziani ME, Manfredi SR, Avesani CM, Sesso R, Cuppari L: Nutritional parameters and mortality in incident hemodialysis patients. J Renal Nutr 16:27-35, 2006
39. Franzosi MG: Should we continue to use BMI as a cardiovascular risk factor? Lancet 368:624-625, 2006
40. Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, Franch H, Guarnieri G, Ikizler TA, Kaysen G, Lindholm B, Massy Z, Mitch W, Pineda E, Stenvinkel P, Treviño-Becerra A, Wanner C: A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int 73:391-398, 2008
41. Janssen I, Katzmarzyk PT, Ross R: Body mass index, waist circumference, and health risk: evidence in support of current National Institutes of Health guidelines. Arch Intern Med 162:2074-2079, 2002
42. Elsayed EF, Sarnak MJ, Tighiouart H, Griffith JL, Kurth T, Salem DN, Levey AS, Weiner DE: Waist-to-hip ratio, body mass index, and subsequent kidney disease and death. Am J Kidney Dis 52:29-38, 2008
43. Sanches FM, Avesani CM, Kamimura MA, Lemos MM, Axelsson J, Vasselai P, Draibe SA, Cuppari L: Waist circumference and visceral fat in CKD: a cross-sectional study. Am J Kidney Dis 52:66-73, 2008
44. Beddhu S, Pappas LM, Ramkumar N, Samore M: Effects of body size and body composition on survival in hemodialysis patients. J Am Soc Nephrol 14:2366-2372, 2003
45. Jolly S, Chatatalsingh C, Bargman J, Vas S, Chu M, Oreopoulus DG: Excessive weight gain during peritoneal dialysis. Int J Artif Organs 24(4):197-202, 2001
46. Ritz E: Why are lipids not predictive of cardiovascular death in the dialysis patient? Miner Electrolyte Metab 22:9-12, 1996
47. Wanner C, Krane V, März W, Olschewski M, Asmus HG, Krämer W, Kühn KW, Kütemeyer H, Mann JF, Ruf G, Ritz E, Deutsche Diabetes-Dialyse-Studie (4D) Study Group: Randomized controlled trial on the efficacy and safety of atorvastatin in patients with type 2 diabetes on hemodialysis (4D Study): demographic and baseline characteristics. Kidney Blood Press Res 27:259-266, 2004
48. Fellström B, Zannad F, Schmieder R: Effect of rosuvastatin on outcomes in chronic haemodialysis patients-design and rationale of the AURORA study. Curr Control Trials Cardiovasc Med 6:9, 2005
49. Duranti E, Imperiali P, Sasdelli M: Is hypertension a mortality factor in dialysis? Kidney Int Suppl 55:S173-S174, 1996
50. Zager PG, Nikolic J, Brown RH, Campbell MA, Hunt WC, Peterson D, Van Stone J, Levey A, Meyer KB, Klag MJ, Johnson HK, Clark E, Sadler JH, Teredesai P: "U" curve association of blood pressure and mortality in hemodialysis patients. Medical Directors of Dialysis Clinic, Inc. Kidney Int 54:561-569, 1998
51. Port FK, Hulbert-Shearon TE, Wolfe RA, Bloembergen WE, Golper TA, Agodoa LY, Young EW: Predialysis blood pressure and mortality risk in a national sample of maintenance hemodialysis patients. Am J Kidney Dis 33:507-517, 1999
52. Aslam N, Bernardini J, Fried L, Piraino B: Large body mass index does not predict short-term survival in peritoneal dialysis patients. Perit Dial Int 22:191-196, 2002
53. Salahudeen AK: Lack of relationship between large body mass and survival on peritoneal dialysis. Is this real? Perit Dial Int 22:634-635, 2002
54. Pliakogiannis T, Trpeski L, Taskapan H, Shah H, Ahmad M, Fenton S, Bargman J, Oreopoulos D: Reverse epidemiology in peritoneal dialysis patients: the Canadian experience and review of the literature. Int Urol Nephrol 39:281-288, 2007
55. Salahudeen AK, Fleischmann EH, Bower JD: Impact of lower delivered Kt/V on the survival of overweight patients on hemodialysis. Kidney Int 56(6):2254-2259, 1999
56. Piraino B, Bernardini J: The effect of body weight on CAPD related infections and catheter loss. Perit Dial Int 11:64-68, 1991
57. Twardowski ZJ: Presternal peritoneal catheter. Adv Ren Replace Ther 9(2):125-132, 2002
58. Zimmerman DG: Presternal catheter design-an opportunity to capitalize on catheter immobilization. Adv Perit Dial 26:91-95, 2010
59. Crabtree JH, Burchette RJ: Comparative analysis of two-piece extended peritoneal dialysis catheters with remote exit-site locations and conventional abdominal catheters. Perit Dial Int 30(1):46-55, 2010
60. Dixon BS: Why don't fistulas mature? Kidney Int 70:1413-1422, 2006
61. Kats M, Hawxby AM, Barker J, Allon M: Impact of obesity on arteriovenous fistula outcomes in dialysis patients. Kidney Int 71:39-43, 2007
62. Dixon BS: Weighing in on fistula failure. Kidney Int 71:12-14, 2007
63. Chan MR, Young HN, Becker YT, Yevzlin AS: Obesity as a predictor of vascular access outcomes: analysis of the USRDS DMMS Wave II study. Semin Dial 21(3):274-279, 2008
64. Lee Timmy, Barker Jill, Allon Michael: Comparison of survival of upper arm arteriovenous fistulas and grafts after failed forearm fistula. J Am Soc Nephrol 18:1936-1941, 2007
65. Weyde W, Krajewska M, Letachowicz W, Porazko T, Watorek E, Kusztal M, Banasik M, Golebiowski T, Bartosik H, Madziarska K, Janczak D, Klinger M: Obesity is not an obstacle for successful autogenous arteriovenous fistula creation in hemodialysis. Nephrol Dial Transplant 23(4):1318-1322, 2008
66. Barnard KJ, Taubman KE, Jennings WC: Accessible autogenous vascular access for hemodialysis in obese individuals using lipectomy. Am J Surg 200(6):798-802, 2010; discussion 802
67. Karam JL, Haddad FF, Medawar W, Daouk M, Khalil I: Tunneled dialysis catheter tip migration in obese and large-breasted individuals. Kidney Int 75:760, 2009
68. Bosticardo GM: Tunnelled dialysis catheter tip migration in obese and large-breasted individuals: an alternative tunnelling technique as partial solution to the problem. Kidney Int 77(10):932-933, 2010
69. Abbot KC, Glanton CW, Agoda LY: Body mass index and enrollment on the renal transplant waiting list in the United States. J Nephrol 16:40-48, 2003
70. Johnson DW, Isbel NM, Brown AM, Kay TD, Franzen K, Hawley CM, Campbell SB, Wall D, Griffin A, Nicol DL: The effect of obesity on renal transplant outcomes. Transplantation 74:675-681, 2002
71. Jindal RM, Zawada ET, Jr: Obesity and kidney transplantation. Am J Kidney Dis 43(6):943-952, 2004
72. Howard RJ, Thai VB, Patton PR, Hemming AW, Reed AI, Van der Werf WJ, Fujita S, Karlix JL, Scornik JC: Obesity does not portent a bad outcome for kidney transplant recipients. Transplantation 73:53-55, 2002
73. Killackey M, Zhang R, Sparks K, Paramesh A, Slakey D, Florman S: Challenges of abdominal organ transplant in obesity. South Med J 103(6):532-540, 2010
74. Sampaio MS, Reddy PN, Kuo HT, Poommipanit N, Cho YW, Shah T, Bunnapradist S: Obesity was associated with inferior outcomes in simultaneous pancreas kidney transplant. Transplantation 89(9):1117-1125, 2010
75. Takata MC, Campos GM, Ciovica R, Rabl C, Rogers SJ, Cello JP, Ascher NL, Posselt AM: Laparoscopic bariatric surgery improves candidacy in morbidly obese patients awaiting transplantation. Surg Obes Relat Dis 4(2):159-164, 2008
76. Foreyt JP, Goodrick GK: Evidence for success of behavior modification in weight loss and control. Ann Intern Med 119(Suppl 2):698-701, 1993
77. MacLaughlin HL, Cook SA, Kariyawasam D, Roseke M, van Niekerk M, Macdougall IC: Nonrandomized trial of weight loss with orlistat, nutrition education, diet, and exercise in obese patients with CKD: 2-year follow-up. Am J Kidney Dis 55(1):69-76, 2010 [Epub 2009 Nov 17]
78. Macdonald JH, Marcora SM, Jibani M, Phanish MK, Holly J, Lemmey AB: Intradialytic exercise as anabolic therapy in haemodialysis patients-a pilot study. Clin Physiol Funct Imaging 25(2):113-118, 2005
79. van den Ham EC, Kooman JP, Schols AM, Nieman FH, Does JD, Akkermans MA, Janssen PP, Gosker HR, Ward KA, MacDonald JH, Christiaans MH, Leunissen KM, van Hooff JP: The functional, metabolic, and anabolic responses to exercise training in renal transplant and hemodialysis patients. Transplantation 83(8):1059-1068, 2007
80. Pagotto U, Vanuzzo D, Vicennati V, Pasquali R: Pharmacological therapy of obesity. G Ital Cardiol (Rome) 9(4 Suppl 1):83S-93S, 2008
81. Singh A, Sarkar SR, Gaber LW, Perazella MA: Acute oxalate nephropathy associated with orlistat, a gastrointestinal lipase inhibitor. Am J Kidney Dis 49:153-157, 2007
82. Courtney AE, O'Rourke DM, Maxwell AP: Rapidly progressive renal failure associated with successful pharmacotherapy for obesity. Nephrol Dial Transplant 22:621-623, 2007
83. Karamadoukis L, Ludeman L, Williams AJ: Is there a link between calcium oxalate crystalluria, orlistat and acute tubular necrosis? Nephrol Dial Transplant 23:1778-1779, 2008
84. Weir MA, Beyea MM, Gomes T, Juurlink DN, Mamdani M, Blake PG, Wald R, Garg AX: Orlistat and acute kidney injury: an analysis of 953 patients. Arch Intern Med 171(7):703-704, 2011
85. Thompson CS, Weinman EJ: The secondary oxalosis of renal failure. Semin Dial 1(2):94-99, 1988
86. Nankivell BJ, Murali KM: Images in clinical medicine. Renal failure from vitamin C after transplantation. N Engl J Med 358(4):e4, 2008
87. McAllister CJ, Scowden EB, Dewberry FL, Richman A: Renal failure secondary to massive infusion of vitamin C. JAMA 252(13):1684, 1984
88. Wong K, Thomson C, Bailey RR, McDiarmid S, Gardner J: Acute oxalate nephropathy after a massive intravenous dose of vitamin C. Aust N Z J Med 24:410-411, 1994
89. Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y: Criteria and recommendations for vitamin C intake. JAMA 281(15):1415-1423, 1999
90. Mandl J, Szarka A, Bánhegyi G: Vitamin C: update on physiology and pharmacology. Br J Pharmacol 157(7):1097-1110, 2009 [Epub 2009 Jun 5]
91. Bhattacharyya S, Schapira AH, Mikhailidis DP, Davar J: Drug induced fibrotic valvular heart disease. Lancet 374(9689):577-585, 2009
92. Glandt M, Raz I: Present and future: pharmacologic treatment of obesity. J Obes 2011:636181, 2011 [Epub 2011 Feb 8]
93. Gill RS, Sharma AM, Al-Adra DP, Birch DW, Karmali S: The impact of bariatric surgery in patients with type-2 diabetes mellitus. Curr Diabetes Rev 7(3):185-189, 2011
94. Castillo J, Fábrega E, Escalante CF, Sanjuan JC, Herrera L, Hernánz F, Martino E, Casafont F, Gómez Fleitas M: Liver transplantation in a case of steatohepatitis and subacute hepatic failure after biliopancreatic diversion for morbid obesity. Obes Surg 11(5):640-642, 2001
95. Franco JV, Ruiz PA, Palermo M, Gagner M: A review of studies comparing three laparoscopic procedures in bariatric surgery: Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and Adjustable Gastric Banding. Obes Surg 21(9):1458-1468, 2011
96. Robert M, Poncet G, Boulez J, Mion F, Espalieu P: Laparoscopic gastric bypass for failure of adjustable gastric banding: a review of 85 cases. Obes Surg 21(10):1513-1519, 2011
97. Gupta PK, Miller WJ, Sainath J, Forse RA: Determinants of resource utilization and outcomes in laparoscopic Roux-en-Y gastric bypass: a multicenter analysis of 14, 251 patients. Surg Endosc 25(8):2613-2625, 2011
98. Maclaughlin HL, Hall WL, Patel AG, Macdougall IC: Laparoscopic Sleeve Gastrectomy is a novel and effective treatment for obesity in patients with chronic kidney disease. Obes Surg 2011, May 25 [Epub ahead of print]
99. Alexander JW, Goodman HR, Gersin K, Cardi M, Austin J, Goel S, Safdar S, Huang S, Woodle ES: Gastric bypass in morbidly obese patients with chronic renal failure and kidney transplant. Transplantation 78(3):469-474, 2004
100. Alexander JW, Goodman H: Gastric bypass in chronic renal failure and renal transplant. Nutr Clin Pract 22:16-21, 2007
101. Modanlou KA, Muthyala U, Xiao H, Schnitzler MA, Salvalaggio PR, Brennan DC, Abbott KC, Graff RJ, Lentine KL: Bariatric surgery among kidney transplant candidates and recipients: analysis of the United States renal data system and literature review. Transplantation 87(8):1167-1173, 2009
102. Majorowicz RR: Nutrition management of gastric bypass in patients with chronic kidney disease. Nephrol Nurs J 37(2):171-175, 2010
103. Rounis E, Laing CM, Davenport A: Acute neurological presentation due to copper deficiency in a hemodialysis patient following gastric bypass surgery. Clin Nephrol 74(5):389-392, 2010
104. Balsa JA, Botella-Carretero JI, Gómez-Martín JM, Peromingo R, Arrieta F, Santiuste C, Zamarrón I, Vázquez C: Copper and zinc serum levels after derivative bariatric surgery: differences between Roux-en-Y gastric bypass and biliopancreatic diversion. Obes Surg 21(6):744-750, 2011
105. Nelson WK, Houghton SG, Milliner DS, Lieske JC, Sarr MG: Enteric hyperoxaluria, nephrolithiasis, and oxalate nephropathy: potentially serious and unappreciated complications of Roux-en-Y gastric bypass. Surg Obes Relat Dis 1(5):481-485, 2005 [Epub 2005 Aug 26]
106. Moutzouris DA, Skaneli G, Margellos V, Apostolou T, Petraki C, Nikolopoulou N: Oxalate nephropathy in a diabetic patient after gastric by-pass. Clin Nephrol 75(Suppl 1):16-19, 2011
107. Nasr SH, D'Agati VD, Said SM, Stokes MB, Largoza MV, Radhakrishnan J, Markowitz GS: Oxalate nephropathy complicating Roux-en-Y Gastric Bypass: an underrecognized cause of irreversible renal failure. Clin J Am Soc Nephrol 3(6):1676-1683, 2008 [Epub 2008 Aug 13]
108. Rogers CC, Alloway RR, Alexander JW, Cardi M, Trofe J, Vinks AA: Pharmacokinetics of mycophenolic acid, tacrolimus and sirolimus after gastric bypass surgery in end-stage renal disease and transplant patients: a pilot study. Clin Transplant 22(3):281-291, 2008