University of Granada. Faculty of Health Sciences, Parque Tecnológico de Ciencias de la Salud. Avd de la Ilustración 60 CP18016, Granada/Spain.
Academic Medical Center Virgen de las Nieves, Nephrology Department. Av. de las Fuerzas Armadas, 2, 18014 Granada Spain.
Int J Med Sci. 2020 Aug 27;17(15):2306-2311. doi: 10.7150/ijms.47000. eCollection 2020.
Patients frequently experience a weight gain after organ transplantation. This increase in weight is the result of multiple factors, and is usually intensified by glucocorticoids and immunosuppressive drugs. It can also delay graft function and cause serious health problems. The objective of this study was to study the obesity as well as its causes and consequences in kidney transplant patients. The sample population consisted of 282 renal transplant patients, 170 men and 112 women, 18-74 years of age, who were monitored over a period of five years. For the purposes of our research, the patients were divided into two groups: (1) normal weight 18.5 ≤ BMI <25; (2) overweight 25 ≤ BMI ≤30. The association between BMI as an independent variable and graft survival was determined by means of a Cox regression analysis. Overweight patients were characterized by a higher comorbidity prevalence. In the Cox multivariate analysis, the initial BMI, evaluated as a continuous variable continued to be an independent predictor of delayed graft function and chronic nephropathy. This study evaluated the BMI as a continuous value instead of a categorical value. In conclusion, our results suggest that an increase in BMI without categorical variation can be an independent risk factor for graft loss. Consequently, obesity prevention for renal transplant patients should include dietary counseling and management, moderate physical activity, and steroid minimization.
患者在器官移植后经常会体重增加。这种体重增加是多种因素造成的,通常会因糖皮质激素和免疫抑制剂的使用而加剧。它还会延迟移植物功能,导致严重的健康问题。本研究的目的是研究肾移植患者的肥胖及其原因和后果。样本人群由 282 名肾移植患者组成,其中 170 名男性和 112 名女性,年龄在 18-74 岁之间,监测时间为五年。为了进行我们的研究,将患者分为两组:(1)正常体重 18.5≤BMI<25;(2)超重 25≤BMI≤30。通过 Cox 回归分析确定 BMI 作为独立变量与移植物存活率之间的关系。超重患者的合并症患病率更高。在 Cox 多变量分析中,初始 BMI(作为连续变量评估)仍然是延迟移植物功能和慢性肾病的独立预测因子。本研究评估了 BMI 作为连续值,而不是分类值。总之,我们的结果表明,BMI 的增加而没有分类变化可能是移植物丢失的一个独立危险因素。因此,肾移植患者的肥胖预防应包括饮食咨询和管理、适度的身体活动和最小化类固醇的使用。