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One‐Year Post‐Transplant Weight Gain is a Risk Factor for Graft Loss
Author(s) -
Ducloux Didier,
Kazory Amir,
SimulaFaivre Dominique,
Chalopin JeanMarc
Publication year - 2005
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2005.01104.x
Subject(s) - medicine , weight gain , creatinine , body mass index , overweight , renal function , transplantation , gastroenterology , urinary system , weight loss , risk factor , hazard ratio , urology , obesity , surgery , confidence interval , body weight
Metabolic syndrome (MS) and obesity participate in the pathogenesis of kidney disease. We explored the impact of MS and post‐transplant weight gain on graft survival. Two hundred ninety‐two renal transplant recipients (RTRs) were included in the study. Various parameters (e.g. anthropometric, biological) were measured at the time of transplantation as well as 1 year post‐transplant. The proportion of patients with overweight or obesity significantly increased during the first year post‐transplant (p = 0.04). Mean weight gain was 2.7 ± 5.8 kg. Thirty patients (10.3%) lost their graft during follow‐up. In multivariate analysis, patients with an increase in body mass index (BMI) of more than 5% at 1 year post‐transplant had an increased risk of graft loss with (HR: 2.82 [95% CI: 1.11–7.44], p = 0.015) or without death censoring (HR: 2.31 [95% CI: 1.06–5.04], p = 0.035). Low creatinine clearance (HR: 4.72 [95% CI: 1.63–13.69], p = 0.004), high urinary protein excretion (HR: 3.21 [95% CI: 1.27–8.18], p = 0.014) and delayed graft function (DGF) (HR: 2.621 [95% CI: 1.07–6.39], p = 0.036) were also independent risk factors for graft loss. MS did not independently predict graft loss, partly due to significant interactions with low‐grade inflammation. We conclude that post‐transplant weight gain significantly reduces graft survival.