The importance of obesity and hyperlipidaemia in patients with renal transplants

Abstract

The authors studied dyslipidaemia and "obesity" in 137 patients (87 males and 50 females) following cadaver renal transplantation with regard to the applied immunosuppressive treatment and the patients' hypertension. The most extreme dyslipidaemic values, the highest levels of total cholesterol, LDL and Apo were found 6 to 18 months after successful transplantation; these values were significantly higher in women than in men. While in the dialysis programme only 21.89% of the patients had BMI values higher than 25.1 kg/m2, after transplantation their proportion was 36.49%. In addition to hyperlipidaemia, hyperuricaemia was encountered in 39.42%, erythrocytosis in 8.76% and diabetes mellitus in 9.48%, respectively. In the group of patients treated only with Cyclosporine-A the incidence of hyperlipidaemia and hypertension was significantly lower than in those receiving a combination of either corticosteroids and Cyclosporine-A or corticosteroids, Cyclosporine-A and azathioprine. There was a close relationship between the unfavourable tendency of obesity and the measured hyperlipidaemia. On the other hand, the extent of proteinuria did not always have a positive correlation with the increase of BMI and body weight, the severity of hypertension and hyperlipidaemia. The authors emphasize the importance of a systematic control of the lipid levels, the significance of a diet with an adequate carbohydrate and lipid content, and the necessity of avoiding obesity by selecting the optimal immunosuppressive treatment.

Diets and enteral supplements for improving outcomes in chronic kidney disease

“…142,143 However, in many transplant recipients, especially in those with chronic allograft nephropathy, a worsening nutritional status is observed similar to that seen in patients with nondialysis-dependent CKD. Several specific factors relating to transplantation can potentially induce PEW in kidney transplant recipients in addition to conditions related to uremia.…”

Identification of Key Pathways and Genes in Obesity Using Bioinformatics Analysis and Molecular Docking Studies

“…Obesity occurs in children age between 5 to 19 years as well as more common in women than in men ( 2 ). Countless surveys have proved that obesity is an key risk factor for heart disease ( 3 ), hyperlipidaemia ( 4 ), hyperinsulinaemia ( 5 ), hypertension ( 6 ), atherosclerosis ( 7 ), insulin resistance ( 8 ) and cancer ( 9 ). Important candidate genes and relevant signaling pathways linked with obesity remains largely unknown.…”

Perioperative risks of bariatric surgery among patients with and without history of solid organ transplant

“…Morbid obesity (body mass index [BMI] ≥35 kg/m 2 ) and obesity-related medical comorbidities are increasingly common among patients with a history of solid organ transplant, mediating inferior long-term graft survival and increased patient mortality. [1][2][3] Limited case series have shown bariatric surgery to be effective among patients with a history of solid organ transplant who qualify for bariatric surgery according to National Institutes of Health and Centers for Medicare & Medicaid Services guidelines (BMI ≥40 kg/m 2 or BMI ≥35 kg/m 2 with ≥1 obesity-related medical comorbidity). 4,5 Benefits include substantial and sustained weight loss; increased immunosuppressive stability; enhanced quality of life; remission of obesity-related medical comorbidities such as diabetes, hypertension, and dyslipidemia;…”

“…Intraabdominal leak was determined by(1) the need for reoperation, endoscopic intervention, or percutaneous drain placement when the listed reason was intraabdominal leak or (2) the presence of an abdominal drain for >30 days from index procedure. Acute kidney injury was defined by the MBSAQIP participant use file as (1) a postoperative rise in serum creatinine >2 mg/dL from the preoperative value or (2) the need for acute dialysis.…”