Effect of Changes in Body Mass Index on Cardiovascular Outcomes in Kidney Transplant Recipients

Kim, K.Y.; Cho, J.-H.; Jung, Hee Yeon; Choi, Ji Young; Park, S.-H.; Kim, C.-D.; Kim, Y.-L.; Ro, Han; Lee, S.; Han, Seungyeup; Jung, Cheol Woong; Park, J.B.; Kim, M.S.; Yang, Jaeseok; Ahn, Curie

doi:10.1016/j.transproceed.2017.03.049

Cited by 5 publications

(8 citation statements)

References 21 publications

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“…Therefore, for transplant patients, it is necessary to reevaluate changes in obesity during the follow-up period. Recently, the impact of post-KT BMI changes on recipient outcomes was reported in large transplant cohorts 19 , 20 . The studies assessed BMI changes during the first year after KT when renal function, water balance, and nutritional status rapidly improved.…”

Section: Discussionmentioning

confidence: 99%

“…The studies assessed BMI changes during the first year after KT when renal function, water balance, and nutritional status rapidly improved. With respect to CVD risk, a cohort consisting of Asian transplant patients showed that consistently high BMI was an important factor predicting new-onset CVD, but increase in BMI was not 20 . However, as changes in body weight and BMI during the first year of KT may not accurately reflect long-term metabolic burdens, it may be important to monitor changes in body composition for more than a year and evaluate their impact.…”

Section: Discussionmentioning

confidence: 99%

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Impact of changes in waist-to-hip ratio after kidney transplantation on cardiovascular outcomes

Gwon

Choi

Jung

et al. 2021

Sci Rep

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Recently, waist to hip ratio (WHR) has been reported to be a better indicator of predicting cardiovascular outcomes than body mass index (BMI). We evaluated the effects of pre or post-transplant changes of WHR or BMI on the new onset cardiovascular diseases (CVD) in recipients of kidney transplantation (KT). A total of 572 patients were enrolled from a multicenter observational cohort (KNOW-KT). Measurement of WHR and BMI was done at pre-KT, first and last visit year after KT, and the changes of these parameters and their effect on the incident CVD were analyzed. During the median follow up period of 32.73 ± 15.26 months, the new onset CVD developed in 31 out of 572 patients. The older age, diabetes mellitus and increase of WHR from pre KT or previous follow up year were found to be independent factors predicting the new onset CVD in these patients. However, baseline BMI, WHR prior to KT did not predict the incident CVD. The new metabolic burden, presented as increase of WHR in KT patients has a critical impact on the development of new onset CVD. Strategies to prevent the metabolic burden after KT might improve cardiovascular outcomes and patient’s survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of changes in waist-to-hip ratio after kidney transplantation on cardiovascular outcomes

Gwon

Choi

Jung

et al. 2021

Sci Rep

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“…Thirteen provided estimates adjusted for potential confounding in western populations [ 31–43 ] while 11 only conducted univariable analyses. Two provided data for Asian populations [ 55 , 56 ].…”

Section: Chapter 2 What Degree Of Obesity (By Level Of Bmi) Influences the Outcomes In Kidney Transplant Recipients?mentioning

confidence: 99%

Management of obesity in kidney transplant candidates and recipients: A clinical practice guideline by the DESCARTES Working Group of ERA

Oniscu

Abramowicz

Bolignano

et al. 2021

Nephrology Dialysis Transplantation

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The clinical practice guideline ‘Management of obesity in kidney transplant candidates and recipients’ was developed to guide decision making in caring for people with end-stage kidney disease living with obesity. The document considers the challenges in defining obesity, weighs interventions for treating obesity in kidney transplant candidates as well as recipients and reflects on the impact of obesity on the likelihood of waitlisting as well as its effect on transplant outcomes. It was designed to inform management decisions related to this topic and provide the backdrop for shared decision making. This guideline was developed by ERA's Descartes working group on Transplantation. The group was supplemented with selected methodologists to supervise the project and provide methodological expertise in guideline development throughout the process. The guideline targets any health care professional treating or caring for people with end-stage kidney disease being considered for kidney transplantation or having received a donor kidney. This includes nephrologists, transplant physicians, transplant surgeons, general practitioners, dialysis and transplant nurses. Development of this guideline followed an explicit process of evidence review. Treatment approaches and guideline recommendations are based on systematic reviews of relevant studies, and appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Limitations of the evidence are discussed, and areas of future research are presented.

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“…The obesity paradox seen for the ESRD transplant candidates does not yet extend to the posttransplant setting, with obesity and weight gain are associated with reduced survival and CVD, as per in the general population [26]. In our view, interventions like BS could therefore have a stronger indication in the post-transplant scenario, but in order to achieve a durable weight loss, a more generalised strategy with lifestyle interventions and physical rehabilitation are paramount.…”

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confidence: 91%

The Conundrum of High Body Mass Index in Kidney Transplant Patients

Bellini¹,

Ayathamattam²,

Herbert³

2018

obm transplant

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Obesity is on the rise and the number of end stage renal disease patients who are obese parallel this trend. There is no universally accepted guideline for wait-listing end stage renal disease obese patients in order to reduce surgical complications and improve survival of the kidney graft. Criteria for acceptance are variable among transplant centres, as do posttransplant policies. Careful risk assessment to maximise the benefits of the limited organ donor resource must be undertaken prior to waitlist an obese kidney transplant candidate. Likewise, close post transplantation follow-up for this higher risk group should be implemented as per the general population, but the body mass index per se should not be a barrier to get access to transplantation.

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Effect of Changes in Body Mass Index on Cardiovascular Outcomes in Kidney Transplant Recipients

Cited by 5 publications

References 21 publications

Impact of changes in waist-to-hip ratio after kidney transplantation on cardiovascular outcomes

Impact of changes in waist-to-hip ratio after kidney transplantation on cardiovascular outcomes

Management of obesity in kidney transplant candidates and recipients: A clinical practice guideline by the DESCARTES Working Group of ERA

The Conundrum of High Body Mass Index in Kidney Transplant Patients

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