Topical Area: Obesity
Objectives : Post-Transplant weight gain is associated with poor renal allograft function. Association between pattern of weight gain at different period after kidney transplantation (KTx) especially during late transplantation and renal allograft function is unclear. We aim to address to potential effect of weight changes on renal allograft function.
Methods : Seventy kidney transplant recipients from a single center were stratified into 4 groups based on weight gain (+) and/or weight loss (-) compared to weight at the time of KTx both at 1 and 6 months post-KTx (Gr1 (-,-), Gr2 (-,+), Gr3 (+,-), Gr4 (+,+)). Decline in renal allograft function defined by dropped in eGFR from baseline eGFR at 1-month post-KTx during 24 months of follow-up in different 4 groups is examined by multivariable Cox proportional hazard regression analysis.
Results : Mean±SD age was 52.66±11.97 years and 59% was male. Mean±SD body mass index (BMI) at the time of KTx was 27.64±5.64 kg/m2. Distribution of patients in 4 groups of Gr1, 2, 3, and 4 were 34, 36, 10, and 20%, respectively and mean BMI of all 4 groups at the time of KTx were not statistically significant (p 0.0981). Mean weight changes among 4 groups based on weight change both at 1- and 6-month post-KTx were summarized in the Table 1. Baseline renal allograft function with a mean eGFR of 50.86±18.90 ml/min/1.73 m2 were not different among all 4 groups (Table 1). Among 70 patients, 43 patients (61%) had a decline in eGFR between 1 and 24 months post-KTx and contributed to the incidence rate of 0.056 person-months. The number of patients with dropped eGFR in Gr1, 2, 3 and 4 were 14 (58%), 14 (56%), 4 (57%), and 11 (79%) patients, respectively. Compared to Gr1, Gr2 had lower, but Gr 3 and 4 had higher the risk for declining eGFR but no statistical significance (HR(95% CI) :0.84 (0.40 – 1.76); 1.18 (0.39-3.60); 1.31 (0.60-2.90)). After adjusted for age, gender, race, types of KTx, systolic and diastolic blood pressure and BMI at the time of KTx, the association remains the same. (HR(95% CI) :0.78 (0.34 – 1.81); 1.66 (0.46-6.04); 1.32 (0.53-3.34)).
Conclusions : Weight loss at very early (1 month) post-KTx appears protective for a decline in renal allograft function during 24 months post-KTx; whereas, weight gain at later time post-KTx (6 months) after initial early weight loss was even associated with better renal allograft outcomes. Factors associated with early post-KTx weight gain may contribute to pathophysiology of poorer renal allograft function.
Funding Sources : None