Kidney Week

Abstract: TH-OR122

Obesity Is Associated with Graft Failure in Pediatric Kidney Transplantation

Session Information

• Predictors of Clinical Outcomes After Kidney Transplantation
  October 25, 2018 | Location: 6C, San Diego Convention Center
  Abstract Time: 04:42 PM - 04:54 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Wasik, Heather Lynn, Johns Hopkins University, Baltimore, Maryland, United States

Heather Lynn Wasik, MD

• Pruette, Cozumel S., Johns Hopkins University, Baltimore, Maryland, United States

Cozumel S. Pruette,

• Ruebner, Rebecca, Johns Hopkins University, Baltimore, Maryland, United States

Rebecca Ruebner,

• Massie, Allan, Johns Hopkins School of Medicine, Baltimore, Maryland, United States

Allan Massie,

Background

Obesity is a potentially modifiable risk factor in kidney transplantation (KT), but recent studies have shown conflicting results regarding the impact of recipient obesity on graft failure in pediatric KT.

Methods

We studied first-time KT recipients 1995-2016 aged 2-17 years at transplant using SRTR data. Using recipients’ height and weight at time of KT, we classified them as underweight (BMI <5^th percentile), normal weight (BMI 5^th to <85^th percentile), overweight (BMI 85^th to <95^th percentile), and obese (BMI ≥ 95^th percentile) based on US CDC growth reference charts. Normal weight recipients were the reference group. Survival analysis was used to compare the cumulative incidence of all-cause graft failure (ACGF) between recipients in each BMI category. Multivariable Cox models were used to compare time to ACGF between recipients in each BMI category, adjusting for recipient, donor, and transplant characteristics.

Results

Of 12,247 pediatric KT recipients, 62.7% were normal weight, 6.9% were underweight, 14.3% were overweight, and 16.1% were obese. Obese KT recipients had the highest incidence of ACGF (37% at 10 years vs 34% for normal/overweight and 32% for underweight (Figure)). After adjustment, obesity remained associated with an increased risk of ACGF (aHR=_1.091.20_1.31, p<0.001).

Conclusion

Obesity at the time of transplantation is associated with increased risk of ACGF in pediatric KT recipients. Obesity may be a modifiable risk factor for graft loss in pediatric KT.

Funding

• Other NIH Support