Hap Katarzyna, Madziarska Katarzyna, Hap Wojciech, Zmonarski Sławomir, Zielińska Dorota, Kamińska Dorota, Banasik Mirosław, Kościelska-Kasprzak Katarzyna, Klinger Marian, Mazanowska Oktawia
Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland.
Second Department of General and Oncological Surgery, Wrocław Medical University, Wrocław, Poland.
Ann Transplant. 2019 Jan 29;24:57-61. doi: 10.12659/AOT.912096.
BACKGROUND Being overweight for kidney transplant recipients can cause serious side effects. Weight gain affects two-thirds of kidney transplant recipients and has been attributed to a more liberal diet after transplantation, recovery of appetite due to lack of uremic toxicity, corticosteroid use, and inadequate lifestyle changes. The aim of this study was to assess gender-dependent profile of body mass index (BMI) changes after kidney transplantation (KTx). MATERIAL AND METHODS Sixty-two kidney transplant recipients (38 males and 24 females), aged 46.0±12.8 years at KTx, were observed according to weight gain after KTx. BMI was calculated before transplantation (pre-KTx) and at 6, 12, and 24 months post-KTx. RESULTS During the 24-month observation period, we found an increase in the incidence of kidney transplant recipients being overweight or obese (pre-KTx 43.5% increase and 24-month post-Ktx 61.3% increase, =0.036). We analyzed a number of factors that could potentially influence a 24-month BMI gain including age at KTx, gender, pre-KTx BMI, time on dialysis, pre-KTx glucose metabolism disorder, and post-KTx diabetes mellitus. For female recipients, there was a significant step-wise post-KTx increase in BMI during the 24-month observation period. The overall pre-KTx to 24-month net increase for female BMI was 2 times greater than that observed for male recipients (1.90±2.20 kg/m² versus 0.89±1.85 kg/m², <0.001). CONCLUSIONS Weight gain after KTx was observed in both sexes, but the net BMI increase was more than 2 times greater in females than in males at 24-months post-KTx. This indicated the need for diet education and strict weight control in kidney transplant recipients, especially in female patients.
背景 肾移植受者超重会导致严重的副作用。三分之二的肾移植受者会出现体重增加，这归因于移植后饮食更为宽松、因尿毒症毒性消失食欲恢复、使用皮质类固醇以及生活方式改变不足。本研究的目的是评估肾移植（KTx）后体重指数（BMI）变化的性别差异情况。 材料与方法 观察了62例肾移植受者（38例男性和24例女性），肾移植时年龄为46.0±12.8岁，根据肾移植后的体重增加情况进行观察。在移植前（KTx前）以及肾移植后6、12和24个月计算BMI。 结果 在24个月的观察期内，我们发现肾移植受者超重或肥胖的发生率有所增加（KTx前增加43.5%，肾移植后24个月增加61.3%，P=0.036）。我们分析了一些可能影响24个月BMI增加的因素，包括肾移植时的年龄、性别、KTx前BMI、透析时间、KTx前糖代谢紊乱以及肾移植后糖尿病。对于女性受者，在24个月的观察期内，肾移植后BMI有显著的逐步增加。女性BMI从KTx前到24个月的总体净增加量是男性受者的2倍（分别为1.90±2.20kg/m²和0.89±1.85kg/m²，P<0.001）。 结论 肾移植后男女均出现体重增加，但肾移植后24个月时女性BMI的净增加量比男性多2倍以上。这表明肾移植受者，尤其是女性患者，需要进行饮食教育和严格的体重控制。
