Pretransplant morbid obesity among patients with end-stage renal disease (ESRD) is a significant predictor of delayed access to transplant and inferior posttransplant patient and kidney allograft outcomes.^1-3 Despite this, policies directly addressing pretransplant weight management do not exist. While the association between bariatric surgery and long-term weight loss and comorbidity improvement among obese patients with ESRD is well established, surgery is underused in this population owing to perceptions of unacceptable increased perioperative risk.^4,5 Perioperative risks of bariatric surgery among obese patients with ESRD are poorly characterized, with limited studies that may not detect rare events.⁶ In this context, we performed an analysis of perioperative safety of bariatric surgery in obese patients with ESRD using a national registry capturing greater than 95% of bariatric operations.

终末期肾病（ESRD）患者的移植前病态肥胖是移植延迟以及移植后患者和同种异体肾移植结果较差的重要预测指标。^{1 -3}尽管如此，还没有直接针对移植前体重管理的政策。尽管肥胖手术患者肥胖症手术与长期体重减轻和合并症改善之间的关系已得到很好的确立，但由于人们认为围手术期风险增加是不可接受的，因此该人群未进行手术。^{4 ，5}肥胖病人中ESRD减肥手术围手术期风险不良的特点，用有限的研究，可能无法检测到罕见的事件。⁶ 在这种情况下，我们使用获得超过95％的减肥手术的国家登记册，对肥胖的ESRD患者进行了减肥手术围手术期安全性的分析。