Montero Nuria, Quero Maria, Arcos Emma, Comas Jordi, Rama Inés, Lloberas Núria, Coloma Ana, Meneghini Maria, Manonelles Anna, Melilli Edoardo, Bestard Oriol, Tort Jaume, Cruzado Josep M
Department of Nephrology, Hospital Universitari de Bellvitge, Barcelona, Spain.
Biomedical Research Institute (IDIBELL), Barcelona, Spain.
Clin Kidney J. 2019 Sep 20;13(6):1068-1076. doi: 10.1093/ckj/sfz124. eCollection 2020 Dec.
Obese kidney allograft recipients have worse results in kidney transplantation (KT). However, there is lack of information regarding the effect of body mass index (BMI) variation after KT. The objective of the study was to evaluate the effects of body weight changes in obese kidney transplant recipients.
In this study we used data from the Catalan Renal Registry that included KT recipients from 1990 to 2011 ( = 5607). The annual change in post-transplantation BMI was calculated. The main outcome variables were delayed graft function (DGF), estimated glomerular filtration rate (eGFR) and patient and graft survival.
Obesity was observed in 609 patients (10.9%) at the time of transplantation. The incidence of DGF was significantly higher in obese patients (40.4% versus 28.3%; P < 0.001). Baseline obesity was significantly associated with worse short- and long-term graft survival (P < 0.05) and worse graft function during the follow-up (P < 0.005). BMI variations in obese patients did not improve eGFR or graft or patient survival.
Our conclusion is that in obese patients, decreasing body weight after KT does not improve either short-term graft outcomes or long-term renal function.
肥胖的肾移植受者在肾移植(KT)中的结果较差。然而,关于肾移植后体重指数(BMI)变化的影响,目前缺乏相关信息。本研究的目的是评估肥胖肾移植受者体重变化的影响。
在本研究中,我们使用了加泰罗尼亚肾脏登记处的数据,该数据包括1990年至2011年的肾移植受者(n = 5607)。计算移植后BMI的年度变化。主要结局变量为移植肾功能延迟恢复(DGF)、估计肾小球滤过率(eGFR)以及患者和移植物生存率。
移植时609例患者(10.9%)存在肥胖。肥胖患者的DGF发生率显著更高(40.4%对28.3%;P < 0.001)。基线肥胖与短期和长期移植物生存率较差(P < 0.05)以及随访期间移植物功能较差(P < 0.005)显著相关。肥胖患者的BMI变化并未改善eGFR、移植物或患者生存率。
我们的结论是,在肥胖患者中,肾移植后体重减轻既不能改善短期移植物结局,也不能改善长期肾功能。