Sleeve gastrectomy versus GLP-1 agonist to improve kidney transplant access in end-stage renal disease patients with obesity: a decision analysis

14% of patients undergoing sleeve gastrectomy received kidney transplantation at 10 years, compared to 2.5% with glucagon-like peptide-1 receptor agonists and <1% with diet and exercise.

• Sleeve gastrectomy may significantly improve access to kidney transplantation for obese patients with end-stage renal disease.
• Only 2.5% of patients using glucagon-like peptide-1 receptor agonists achieved transplantation within the same timeframe.
• Less than 1% of patients who followed diet and exercise strategies received a kidney transplant at 10 years.
• Sensitivity analysis suggests sleeve gastrectomy offers a survival advantage over diet and exercise and glucagon-like peptide-1 receptor agonists at specific BMI thresholds.

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