Kidney Week

Abstract: TH-PO994

Obesity: A Risk Factor for Hypertension after Kidney Transplantation

Session Information

• Transplant Recipient Education, Adherence, and Novel Risk Factors for Graft Loss
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• Tantisattamo, Ekamol, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, United States

Ekamol Tantisattamo,

• Vutthikraivit, Possawat, PHRAMONGKUTKLAO COLLEGE OF MEDICINE, BANGKOK, Thailand

Possawat Vutthikraivit,

Background

Hypertension (HTN) after kidney transplantation is common. Underweight leads to unfavorable outcomes in ESRD. The magnitude of risk factors including obesity after kidney transplantation is unclear.

Methods

Seventy kidney transplant recipients were enrolled in a retrospective closed cohort study. Post-transplant HTN is defined as SBP ≥ 140 mmHg first detected after 1-month post-transplantation. The incidence of HTN and the association between potential risk factors and post-transplant HTN were determined.

Results

Mean age was 52.66±1.43 years old and 41 patients (58.6%) was male. There were 49 patients (70%) diagnosed with post-transplant HTN, which was an account of the incidence of post-transplant HTN was 48.67 person-year. Mean SBP and DBP at the time of diagnosis were 151 mmHg; whereas, SBP and DBP of the remaining 21 patients (30%) without post-transplant HTN were 119 mmHg, respectively (p= 0.0167, mean difference 31.79, CI 5.9367 to 57.6433). Several traditional risk factors for HTN were examined and pre-transplant obesity (BMI ≥30 kg/m²) and old age (≥ 65 years old) were significantly associated with post-transplant HTN (RR 1.382 (CI 1.050 to 1.819) and RR 1.6 (1.306 to 1.96); Table)). By using binary logistic regression analysis, post-transplant HTN was 1.140 times greater in obese than in non-obese patients after adjusted for age, gender, race, pre-transplant BMI, and eGFR at transplant discharge (CI 1.006 – 1.291, p=0.040).

Conclusion

Although the reverse epidemiology of non-obesity leading to potential harmful effect in ESRD patients, pre-transplant obesity can lead to poor post-transplant cardiovascular outcomes. Since obesity continues carrying and remains one of the traditional risk factors of HTN after successful kidney transplantation, pre-transplant weight control is still warranted.

Association between systolic hypertension beyond 1-month post-kidney transplantation and its potential risk factors

BMI, body mass index; CI, confidence interval; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate (ml/min/1.73m2); RR, relative risk