Kidney Week

Abstract: TH-PO141

Obesity as a Predictor of Renal Allograft Function

Session Information

• Transplantation: Cardiovascular and Metabolic Diseases
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Luke, Nathan A., Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States

Nathan A. Luke,

• Tantisattamo, Ekamol, University of California Irvine School of Medicine, Orange, California, United States

Ekamol Tantisattamo,

Background

While being underweight in ESRD is associated with increased morbidity and mortality, obesity in these patients leads to unfavorable post-transplant outcomes. The aim of this study is to explore associations between pre-transplant obesity and early readmission (ERA), as well as renal allograft function at 12 months post-transplantation.

Methods

Demographic data of 84 patients receiving a kidney transplantation from January to December 2014 were retrieved. The patients were categorized into non-obese and obese groups based on BMI. ERA, defined as any admission within 30 days after the discharge date from transplant admission, and eGFR was associated with pre-transplant obesity status.

Results

Of all 83 patients, 53 were non-obese and the remaining 30 patients were obese with mean BMIs of 24.65±3.08 and 34.12±2.98, respectively (95% CI -10.85, -8.09, p <0.001). Pre-transplant diabetes were lower in the non-obese group than in the obese group (30% vs 60%, p 0.015); otherwise, all other baseline characteristics between non-obese and obese groups were similar. There were 19, 4, and 2 patients who had 1, 2, and 3 ERA, respectively. One patient died at the early post-transplant period. The remaining 57 patients were never readmitted. Obese patients had 33% higher odds of being readmitted when compared to non-obese patients (OR 1.33, 95% CI 0.50, 3.51, p 0.562). Among 50 non-obese and 28 obese patients with functioning allografts at 12 months post-transplantation, mean eGFR at 12 months was 59.4±19.55 and 50.9±15.81 ml/min/1.73 m², respectively. Obese patients had a decrease in eGFR of 8.56 ml/min/1.73 m² at 12 months post-transplantation compared to non-obese patients (95% CI -17.17 to 0.04, p 0.051). After adjusted for all variables including age, race, type of kidney transplantation, induction immunosuppressive medications, pre-transplant diabetes, hypertension, hyperlipidemia, and smoking, obese patients had a significant decrease in eGFR at 12 months post-transplantation by 10.10 ml/min/1.73 m²when compared to non-obese patients (95% CI -20.18 to -0.02, p-value 0.0495).

Conclusion

Although ESRD patients who are underweight are at risk of poor outcomes during the pre-transplant period, pre-transplant obesity increases the risk of poorer renal allograft function. Patients who will undergo a kidney transplantation should control and maintain their weight in a normal range.