de Oliveira C M C, Moura Á E F, Gonçalves L, Pinheiro L S F, Pinheiro F M L, Esmeraldo R M
Unichristus Medical School, General Hospital of Fortaleza and Federal University of Ceara-Fortaleza, Brazil.
Unichristus Medical School-Fortaleza, Ceara, Brazil.
Transplant Proc. 2014 Jul-Aug;46(6):1735-40. doi: 10.1016/j.transproceed.2014.05.027.
Weight gain after renal transplantation has a multifactorial etiology, which can be associated with complications such as hypertension, dyslipidemia and diabetes, with a probable impact on cardiovascular morbidity and mortality post-transplantation.
The objectives of this study were to investigate the prevalence of weight gain and obesity post-transplantation among renal recipients of a hospital and to evaluate the impact of immunosuppressive therapy without steroids.
We have evaluated all patients who had kidney transplantations performed between January 2005 and December 2009 at General Hospital of Fortaleza, who were older than 18 years of age and had at least 12 months of follow-up post-transplantation. Overweight was defined as body mass index (BMI) between 25 and 30 kg/m(2) and obesity >30 kg/m(2). The association between weight gain and the following variables was investigated: age and gender of the recipient and the donor, donor type, steroid use, presence of systemic arterial hypertension (SAH) and diabetes mellitus, creatinine, glucose, cholesterol, and triglycerides.
The study population included 203 recipients; 59.5% were males, their mean age systemic arterial hypertension (SAH) was 37 years, and 64.2% had deceased donors. In regard to immunosuppression, 41.3% made use of steroids. After 36 months of follow-up, the average weight gain was 6.6 kg in relation to the first month post-transplantation. Among the variables studied, the recipient's younger age and female gender, the younger donor, and the creatinine level were associated with greater weight gain after 36 months of transplantation.
The percentage of weight gain was on average 9% after 36 months post-transplantation, although the prevalence of overweight and obesity increased significantly in the same period. The use of steroid therapy had no impact on the percentage of weight gain post-transplantation, and association was observed only between the younger age and the female gender of the recipient, the younger donor age, and the creatinine level with the highest weight gain post-transplantation.
肾移植后体重增加有多种病因，可能与高血压、血脂异常和糖尿病等并发症相关，对移植后心血管发病率和死亡率可能产生影响。
本研究的目的是调查某医院肾移植受者移植后体重增加和肥胖的患病率，并评估无类固醇免疫抑制治疗的影响。
我们评估了2005年1月至2009年12月在福塔雷萨综合医院接受肾移植的所有患者，这些患者年龄超过18岁，移植后至少随访12个月。超重定义为体重指数（BMI）在25至30kg/m²之间，肥胖定义为BMI＞30kg/m²。研究了体重增加与以下变量之间的关联：受者和供者的年龄及性别、供者类型、类固醇使用情况、系统性动脉高血压（SAH）和糖尿病的存在、肌酐、血糖、胆固醇和甘油三酯。
研究人群包括203名受者；59.5%为男性，他们的平均年龄系统性动脉高血压（SAH）为37岁，64.2%的供者为已故供者。在免疫抑制方面，41.3%的患者使用了类固醇。随访36个月后，与移植后第一个月相比，平均体重增加了6.6kg。在研究的变量中，受者年龄较小、女性性别、供者年龄较小以及肌酐水平与移植36个月后体重增加较多有关。
移植后36个月时体重增加的平均百分比为9%，尽管同期超重和肥胖的患病率显著增加。类固醇治疗的使用对移植后体重增加的百分比没有影响，仅观察到受者年龄较小和女性性别、供者年龄较小以及肌酐水平与移植后体重增加最多之间存在关联。
