Obesity, Hypertension and Renal Dialysis

I recently saw a patient who weighed about 280 pounds, at least 100 pounds overweight who was on chronic renal dialysis. When I asked why he had end stage kidney failure requiring dialysis I expected to hear about obesity related diabetes having destroyed his kidneys. But I was surprised to learn that it was because of hypertension. I was surprised because most hypertension can be controlled and managed with effective blood pressure medication. I asked why his condition, which developed over 15 years ago was never treated and he said that he didn’t have the money. I asked about medication samples and compassionate care. But he said there were no samples medications and compassionate care to help needy patients get low or no cost medications was not made available to him. It was sad and disappointing to hear that for the lack of a relatively inexpensive medication taken once a day, a lifetime of expensive and disruptive renal dialysis was required. His weight loss would have helped reduce his hypertension as well as some important dietary changes would have also helped. But the concept of how a timely intervention with the proper medication could have changed his life for the better and reduced a costly health care burden for both this patient and our health care system is a sobering thought. Because the rates obesity are increasing now at a faster rate then 10-15 years ago and with the many associated medical conditions linked to excess weight it’s now even more important to realize that losing excess weight is the most significant step towards a better and healthier quality of life. It really is important that you take care of yourself. Peter Vash, M.D.