Post-graduate Program in Medical Sciences: Endocrinology, School of Medicine, Universidade Federal do Rio Grande do Sul Faculdade de Medicina, Porto Alegre, Brazil.
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
PLoS One. 2020 Dec 28;15(12):e0243394. doi: 10.1371/journal.pone.0243394. eCollection 2020.
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.
The objective of this study was to identify the risk factors of one-year weight gain after renal transplantation.
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.
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.
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.
肾移植是终末期肾病患者进行肾脏替代治疗的最佳方式。然而，它与体重增加和代谢异常有关，这对移植结果有不利影响。
本研究旨在确定肾移植后一年内体重增加的危险因素。
这是一项回顾性队列研究，共纳入 374 例于 2006 年 1 月至 2013 年 7 月期间接受肾移植的患者。从电子病历中收集临床和实验室变量，观察指标为肾移植后一年内的体重增加。数据以均数±标准差、中位数（四分位间距）或例数（%）表示。采用卡方检验和方差分析比较变量之间的关系。多变量逻辑回归模型用于分析与研究结局相关的危险因素。
181 例（48.4%）患者为女性，334 例（89.3%）为白种人，平均年龄为 44.4±12.8 岁。移植前平均 BMI 为 24.7±4.1kg/m2，35 例（9.9%）患者为肥胖，119 例（33.6%）为超重，187 例（52.8%）为正常体重，13 例（3.7%）为消瘦。随访 1 年后，平均 BMI 为 26.2±5.0kg/m2，61 例（17.3%）患者为肥胖，133 例（37.8%）为超重，148 例（42.0%）为正常体重，10 例（2.8%）为消瘦。72.7%的患者出现体重增加，平均增加 7.12±5.9kg。女性、移植前体重较低、住院次数较少以及活体供肾与移植后 1 年内体重增加超过 5%有关。
女性和移植前较低的体重与肾移植后 1 年内体重增加超过 5%独立相关；较低的住院率和活体供肾也是这一结果的危险因素。
