Post written by Avik Sarkar, MD, from the Department of Gastroenterology, Robert Wood Johnson Medical Center, New Brunswick, New Jersey, USA.
We describe the case of a 51-year-old woman with diabetes, uncontrolled hypertension, ESRD on PD for 3 years, and morbid obesity that failed to respond to lifestyle and dietary modification for weight loss. The patient could not be listed for a kidney transplant due to her morbid obesity. She was offered ESG as a bridge to being listed for a transplant. We showcased a successful ESG procedure in this patient. At 2month follow-up, the patient had lost 29 lbs, BMI was reduced from 46.35 kg/m2 to 43 kg/m2, and BP was well controlled using only half of pre-procedure medication.
We demonstrate that ESG is the most feasible therapeutic bariatric procedure for obese PD patients who have failed conservative management. ESG may be used as a bridge for patients who are ineligible to be listed for kidney transplant due to severe obesity. We recommend patients be treated with 5 days of prophylactic antibiotics due to increased incidence of infection in this population.
This case represents the safety and efficacy of ESG in an ESRD patient on PD. ESG should be considered the first line therapeutic weight-loss option in this patient population who have failed diet and lifestyle modification and may be used as a bridge to kidney transplantation.
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