This leaflet answers common questions about the Kidney Fitness for Transplant (K-FiT) clinic. If you would like further information or have any worries, please do not hesitate to ask your nurse or doctor.

In all cases, a doctor will explain the purpose and aims of the clinic to you and answer any questions you may have.

In most cases it will be possible for a friend or relative to accompany you for all or part of your clinic appointments. Please ask your nurse or doctor.

What is the K-FiT clinic?

As you may have been told by your kidney healthcare team, a kidney transplant can improve quality of life and life expectancy. Before you can be deemed suitable for a kidney transplant, you will need to undertake a full assessment. This includes checking whether you are a suitable weight to undergo the procedure.

If you are not a suitable weight to undergo a kidney transplantation, it may be necessary for you to lose weight to be put on the transplant waiting list (known as ‘being activated’). If this is the case for you, you may be referred to the K-FiT clinic.

The K-FiT clinic is designed to support people to lose sufficient weight to enable them to ‘be activated’ on the kidney transplant waiting list. Patients who are eligible to be seen in the clinic will be seen every few weeks (frequency may vary slightly as you progress through the programme) for six months by our team.

What are the benefits of the K-FiT clinic?

We understand that people living with obesity may have previously explored ways of losing weight. Participation in a programme that includes support from a team of healthcare professionals is proven to help people lose weight and maintain weight loss over time.

Carrying less weight around your abdomen will help to reduce the risks during a kidney transplant. People with a healthy body weight are more likely to keep their transplanted kidney for longer.

Losing weight can also help improve your overall wellbeing and quality of life by making you feel better physically.

Who will I be seen by in clinic?

The K-FiT clinic is delivered by a variety of kidney health professionals. During your clinic visits, you will have appointments with:

  • Dietitians.
  • Physiotherapists.
  • Psychologists.
  • Renal pharmacists.

Before being invited to attend the K-FiT clinic, a renal transplant surgeon will review your medical notes to confirm you're eligible to take part. Though you will not meet with the transplant surgeon in the K-FiT clinic, they will be involved in your care by monitoring your progress with the rest of the clinical team at weekly review meetings.

What happens at my clinic visits?

Psychologist appointments

As part of the programme, you will see a psychologist who specifically understands the impact kidney disease can have on your psychological and physical wellbeing, as well as the challenges involved in weight loss and weight management.

Your initial appointment with the psychologist/therapist will focus on your motivation for starting the programme, possible barriers, and any questions you may have about the programme. You will then be offered a follow-up appointment approximately two weeks later and a further, final appointment about 12 weeks into the programme.

The psychologist will work collaboratively with you to help you explore and alter the factors that may be affecting your eating, food choices and other behaviours related to managing your weight. They will also help you set goals and offer strategies to support you to respond to situations differently to establish new healthy habits and lifestyle choices.  

Dietitian appointments

As part of the programme, you will see a dietitian who will discuss your individual dietary needs to help you on your weight loss journey.

You will be offered an initial assessment to understand your current diet and make a plan that works for you. You will then have five follow-up appointments every four weeks.

Physiotherapist appointments

On the programme, you will be offered an initial appointment with a physiotherapist who will discuss your individual exercise needs to help improve your overall fitness and quality of life. 

You will then be invited to attend an individual follow-up session with a physiotherapist or therapy assistant every four to six weeks to discuss any concerns and options for progress. The programme will consist of six sessions.

In between your sessions you will be directed to Kidney Beam, a website which provides online exercises to follow in your own time.

Renal pharmacist appointments

Some patients may be offered a drug named Semaglutide. When Semaglutide is taken together with a healthy diet and exercise, it may increase the amount of weight you lose by reducing your appetite and making you feel fuller for longer. 

If you are deemed to be a good candidate to take Semaglutide to complement your weight loss journey, you will meet with the renal pharmacist monthly to manage your dosage and review your experience of taking the drug. Your dietitian will also discuss how this may impact your overall weight loss at your initial dietetic appointment. 

Semaglutide is taken once a week. You will initially be started on a low dose, and it will be increased monthly depending on your response to it.

What happens after I have attended the clinic?

After completing the six-month programme, patients will either: 

  • Be activated on the transplant waiting list.
  • Be offered a conversation with a bariatric weight loss surgeon, or 

  • Be offered the opportunity to continue in the clinic for a further six months.