Poster Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2026

A Path to Transplantation: Multidisciplinary VLED Outcomes in Dialysis-Dependent Patients  (#111)

Caitlin Merz 1 2 , Andrea Cawte 1 3 , William Beningfield 1 4 , Helen d'Emden 1 3 , Scott Ruddell 1 5 , Matthew Seymour 1 6 , Keren Singh 1 , Gemma Woodruff 1 2 , Abby Yu 1 2 , Robin Hay 1 3 , Helen MacLaughlin 1 3 7
  1. Tertiary Obesity Multidisciplinary Service, Royal Brisbane and Womens Hospital, Brisbane, QLD, Australia
  2. Pharmacy Department, Royal Brisbane and Womens Hospital, Brisbane, Queensland, Australia
  3. Nutrition Research Collaborative, Royal Brisbane and Womens Hospital, Brisbane, Queensland, Australia
  4. Physiotherapy Department, Royal Brisbane and Womens Hospital, Brisbane, Queensland, Australia
  5. Psychology Department, Royal Brisbane and Womens Hospital, Brisbane, Queensland, Australia
  6. Endocrinology Department , Royal Brisbane and Womens Hospital, Brisbane, Queensland, Australia
  7. School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD , Australia

Very low energy diets (VLEDs) are an established intervention for obesity management and have been investigated in dialysis-dependent populations. However, concerns regarding fluid management, hyperkalaemia, and the need for close clinical monitoring may limit their implementation in routine practice. 

To evaluate weight-related, clinical, and functional outcomes of a multidisciplinary VLED program delivered collaboratively by a tertiary obesity service and renal team in dialysis-dependent patients requiring weight loss to support kidney transplant eligibility. 

Nine dialysis-dependent patients were referred for weight loss to support consideration for kidney transplantation and undertook a 12-week VLED. Meal replacement products were introduced gradually, one per week, up to three daily by program end. Dry weight, VLED modifications, potassium, and medications were reviewed weekly. Weight, body mass index (BMI), waist circumference, and six-minute walk test (6MWT) distance were measured at baseline and 12 weeks. 

The cohort achieved a mean individual weight loss of 9.27 kg (SD 7.07; 95% CI 3.8–14.7 kg), mean BMI reduction of 2.99 kg/m² (SD 2.35; 95% CI 1.19–4.79), and mean waist circumference reduction of 8.22 cm (SD 6.52). Weight loss necessitated frequent dialysis prescription adjustments, with 45 dry weight reductions recorded during the intervention. Hyperkalaemia was managed through regular biochemical monitoring, dietary modification for four patients, and medication titration, resulting in 21 medication dose reductions and 10 dose increases, primarily involving potassium-binding therapy. Mean 6MWT distance improved by 107.1 m (SD 118.0; 95% CI 16.4–197.8 m). Two patients were listed for transplantation during the program, and a further patient was listed following completion and subsequently underwent transplantation. 

Clinically meaningful weight loss can be achieved in dialysis-dependent patients using a multidisciplinary VLED model, with close monitoring enabling safe management of hyperkalaemia and fluid-related changes.