Management of obesity in kidney transplant candidates and recipients: A clinical practice guideline by the Descartes working group of ERA.

The clinical practice guideline 'Management of obesity in kidney transplant candidates and recipients' was developed to guide decision making in caring for people with end-stage kidney disease living with obesity. The document considers the challenges in defining obesity, weighs interventions for treating obesity in kidney transplant candidates as well as recipients and reflects on the impact of obesity on the likelihood of waitlisting as well as its effect on transplant outcomes. It was designed to inform management decisions related to this topic and provide the backdrop for shared decision making. This guideline was developed by ERA's Descartes working group on Transplantation. The group was supplemented with selected methodologists to supervise the project and provide methodological expertise in guideline development throughout the process. The guideline targets any health care professional treating or caring for people with end-stage kidney disease being considered for kidney transplantation or having received a donor kidney. This includes nephrologists, transplant physicians, transplant surgeons, general practitioners, dialysis and transplant nurses. Development of this guideline followed an explicit process of evidence review. Treatment approaches and guideline recommendations are based on systematic reviews of relevant studies, and appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Limitations of the evidence are discussed, and areas of future research are presented.