Background

Bariatric surgery has proven to be effective for patients with obesity and ESRD hoping to undergo kidney transplantation (KT). However, there is a lack of specific guidelines to address the nutritional management for pre-bariatric and post-bariatric surgery. Here, we conduct a literature search to present these dietetic plans.The authors reviewed all English language articles published in PubMed, Ovid, Embase, and Web of Science between 2000-2021 reporting outcomes on bariatric diet pre-and post-bariatric surgery for patients with obesity and ESRD. 28 studies (excluding literature reviews) were included.A total of 7870 patients on dietetic plans consisting of 22 pre-bariatric studies and 6 post-bariatric studies were included. Prior to bariatric surgery, very-low-calorie diets between 450-800 kcal/day show better patient compliance, higher postoperative weight loss, and fewer post-operative complications. Patients should limit their sodium and potassium intake to less than 250 mg and 450 mg, respectively per serving. Many studies recommended having patients take vitamin supplements and achieving a maximum of 8% weight loss before surgery. After bariatric surgery, a progression from liquids to solids for 6-8 weeks is recommended with a minimum protein intake of 60 g/day. Studies showed better quality of life when patients consumed enough protein and fluids daily.We present the current nutritional guidelines for patients with obesity and ESRD before and after bariatric surgery prior to kidney transplantation. We did not find any studies that presented plans for balancing electrolytes. Present guidelines are scarce and further research focusing on electrolyte levels may be advantageous.