Longitudinal changes in body mass index following renal transplantation in UK children

Abstract

The prevalence of patients classified as overweight or obese in the UK paediatric renal cohort is high pre-transplantation and rises subsequently. Those at risk can be identified by an unhealthy BMI pre-transplantation and will require timely intervention with close monitoring in the subsequent post-transplantation period.

Decreased Arterial Elasticity in Children With Nondialysis Chronic Kidney Disease Is Related to Blood Pressure and Not to Glomerular Filtration Rate

“…29,30 In children with CKD, BP control deteriorates with worsening renal function, 31,32 and both BP and BMI increase after transplantation from pretransplantation levels. [33][34][35][36] We would suggest, therefore, that persistently, high BP and BMI in children with predialysis CKD are likely to lead to increased functional stiffness of the carotid artery. BP reduction may be an effective means to protect against arterial stiffening or remodeling in children with CKD and hypertension that persists into adulthood.…”

Paediatric obesity and renal transplantation: current challenges and solutions

“…In contrast, in a multivariate regression analysis of interval increases in BMI z-score following transplantation, there was no apparent effect of increased weight on estimated GFR [6]. This finding was supported by a 4-year follow-up study of estimated GFR in a large multi-centre UK study of normal, overweight and obese paediatric renal transplant patients [24].…”

“…Following renal transplantation, over 50 % of children are classed as overweight or obese compared with approximately 30 % prior to transplantation, with most experiencing rapid and sustained weight gain in the first few months after surgery [6,24,35]. The primary driver for post-operative weight gain was found to be excess weight before transplantation.…”

UK Renal Registry 19th Annual Report: Chapter 9 Clinical, Haematological and Biochemical Parameters in Patients on Renal Replacement Therapy in Paediatric Centres in the UK in 2015: National and Centre-specific Analyses

“…Improvements to the completeness of Ht and Wt in the quarterly data should allow growth rates to be evaluated in the future. These data will also allow evaluation of excessive Wt gain following kidney transplantation [9], identified as the most prevalent CVRF in children receiving RRT.…”