Weight Gain in Renal Transplant Recipients in a Polish Single Centre

Mucha, Krzysztof; Foroncewicz, Bartosz; Ryter, M; Florczak, Michał; Krajewska, Monika; Mulka-Gierek, Maria; Jabiry-Zieniewicz, Zoulikha; Chmura, A.; Lisik, Wojciech; Nazarewski, Sławomir; Pączek, Leszek

doi:10.12659/aot.892754

Cited by 12 publications

(3 citation statements)

References 20 publications

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“…Pre-transplant weight is an important factor to be considered when dealing with kidney transplant patients. Two recent studies reported that 29% and 38% of patients on the waitlist for renal transplantation were diagnosed as overweight or obese, respectively [32,33]. In our study, the prevalence of overweight or obesity pre-transplantation was even higher (approximately 43.5%), reaching a prevalence of 55.1% at 12 months post-transplantation.…”

Section: Plos Onesupporting

confidence: 43%

Risk factors associated with weight gain after kidney transplantation: A cohort study

et al. 2020

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Background Renal transplantation is the best modality of renal replacement therapy for patients with end-stage renal disease. However, it is associated with weight gain and metabolic abnormalities, which adversely impact transplant outcomes. Objective The objective of this study was to identify the risk factors of one-year weight gain after renal transplantation. Methods A retrospective cohort study was conducted with 374 patients that underwent kidney transplantation between January 2006 and July 2013. Clinical and laboratory variables were collected from electronic records, and the outcome of interest was weight gain during the first year after renal transplantation. The data were reported as mean ± standard deviation, median (interquartile range) or number of subjects (%). The association between variables were assessed via chi-square test and ANOVA. For analysis of risk factors related to the outcomes of interest, multivariable logistic regression models were used. Results There were 181 (48.4%) female patients, 334 (89.3%) with white ethnicity and the mean age was 44.4 ± 12.8 years. The mean BMI pre-transplant was 24.7 ± 4.1 kg/m2, and 35 (9.9%) patients were classified as obese; 119 (33.6%) as overweight; 187 (52.8%) as normal weight; and 13 (3.7%) as malnourished. After one year of follow-up, the mean BMI was 26.2 ± 5.0 kg/m2, and 61 (17.3%) patients were classified as obese; 133 (37.8%) as overweight; 148 (42.0%) as normal weight; and 10 (2.8%) as malnourished. Weight gain was observed in 72.7% patients, and the average increase was 7.12 ± 5.9 kg. The female gender, lower pre-transplant body weight, lower number of hospitalizations, and a kidney received from a living donor were associated with weight gain by more than 5% in the first year post-transplant. Conclusion Female gender and lower pre-transplant body weight were independently associated with weight gain by more than 5% in the first year after kidney transplantation; lower rates of hospitalization and donation from living donors were also risk factors for this outcome.

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Section: Plos Onesupporting

confidence: 43%

Risk factors associated with weight gain after kidney transplantation: A cohort study

et al. 2020

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“…It was previously shown that KTRs gain an average of 4.1 kg of weight during the first year after transplantation, which constitutes about 7% of their BMI. Since the majority of KTRs showed insufficient knowledge about overweight or obesity prevention and possible consequences, including hypertension, appropriate educational programs should be considered for this group of patients [ 21 ]. Another risk factor for post-transplant hypertension in KTRs is donor age [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Blood Pressure on Risk of Graft Failure or Death Among Patients After Kidney Transplantation in a 10-Year Observational Period: A Single-Center Retrospective Analysis

Pilecki,

Czarkowska-Pączek,

Lisik

et al. 2023

Ann Transplant

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Background Hypertension is a risk factor for graft failure and mortality among kidney transplant recipients (KTRs). The aim of the study was to examine blood pressure (BP) as a factor that contributes to graft failure or death during a 10-year observation period. Material/Methods The study group comprised 70 KTRs who were treated according to their clinical state. Data were collected at 1 month and 1 year after transplantation and included office and ambulatory BP monitoring (ABPM) BP values, eGFR, proteinuria, and BMI. During the observation period, 6 patients died, and 10 lost the graft, but not during the first year. Results Office and ABPM BP values were within normal ranges and did not differ from each other. eGRF and BMI were higher at 1 year compared to 1 month after transplantation, and proteinuria decreased. Among those who died, DBP was lower compared to those of survivors with graft failure. Proteinuria and donor age were positively correlated with BP. Conclusions Monitoring of BP and adequate treatment of hypertension resulting in BP values within normal values among KTRs contribute to longer survival of the graft and recipient. Older donor age and proteinuria could predict post-transplant hypertension. Low diastolic BP of the recipient could increase the risk of death among KTRs. Despite the fact that ABPM is the blood pressure measurement method of choice, appropriate standard office measurement could also be used for BP monitoring.

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“…A special population among obese patients is a subgroup of those who undergo organ transplantation. The high prevalence of obesity among those patients is mainly due to the fact that obesity promotes end-stage organ disease, and that transplantation causes an increase in body weight [ 5 , 6 ]. A body mass index (BMI) > 40 kg/m 2 is a contraindication for listing in many transplant programs, and some will not accept patients with a BMI > 35 kg/m 2 until they lose weight.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Obesity and Associated Comorbidities on the Outcomes after Renal Transplantation with a Living Donor vs. Deceased Donor Grafts

Yemini

Rahamimov

Nesher

et al. 2022

JCM

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Background: Obesity among kidney transplant (KT) recipients can lead to metabolic comorbidity-associated deaths. This study compares post-KT survival between obese and non-obese patients and outcomes of living donor (LD) and deceased donor (DD) grafts. Methods: Between January 2005–May 2019, 1403 KT recipients from a single center were included in the study, as well as 314 patients (22.4%) with obesity (BMI > 30 kg/m2), 137 DD transplants, and 177 LD transplants. Of the 1089 (77.6%) in the control group (BMI ≤ 30 kg/m2), 384 were DD transplants and 705 LD transplants. The Kaplan–Meier method was used for survival analysis and a Cox regression was used to identify risk factors for graft loss and mortality. Propensity score matching analysis adjusting for age, IHD, and T2DM was performed. Results: The study group had higher incidence of obesity related comorbidities, delayed graft function and primary non function (p < 0.001). One-, 5-and 10-year patient and graft survival were lower in the study group (p < 0.001). Subgroup analysis of graft survival according to type of graft shows a difference in the DD (p = 0.002) but not in the LD group (p = 0.220). However, mortality was higher in both groups (LD, p = 0.045; DD, p = 0.004). Risk factors for mortality were age, T2DM, IHD, and DD, and for graft failure: IHD, BMI, donor age, re-transplant, and DD. Propensity score analysis shows an odds ratio of 0.81 for graft failure and 0.93 for death in the study group (95% CI = 0.55, 1.21, p = 0.3 and CI = 0.59, 1.46, p = 0.7, respectively). Conclusions: Recipient age and metabolic comorbidities should be emphasized when evaluating patients with obesity. We suggest considering weight loss interventions using the new GLP-1 inhibitors and bariatric procedures in selected patients to prepare overweight patients for transplant.

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Weight Gain in Renal Transplant Recipients in a Polish Single Centre

Abstract: BMI increases significantly after RT and is associated with higher risk of NODAT, but most RTRs are not aware of their BMI. Therefore, educational programs for this patient population should be created.

Cited by 12 publications

References 20 publications

Risk factors associated with weight gain after kidney transplantation: A cohort study

Risk factors associated with weight gain after kidney transplantation: A cohort study

Impact of Blood Pressure on Risk of Graft Failure or Death Among Patients After Kidney Transplantation in a 10-Year Observational Period: A Single-Center Retrospective Analysis

The Impact of Obesity and Associated Comorbidities on the Outcomes after Renal Transplantation with a Living Donor vs. Deceased Donor Grafts

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