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Abstract: FR-PO1133

Pre-Transplant Body Mass Index as a Risk for Late Post-Kidney Transplant Hypertension: A Propensity Score Weighting

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Tantisattamo, Ekamol, University of California Irvine School of Medicine, Orange, California, United States
  • Duangkham, Samapon, Faculty of Medicine Burapha University, Saraburi, Thailand
  • Worapongsatitaya, Pitchaya, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
  • Tantivit, Nessa, Faculty of Medicine Siriraj Hispital, Mahidol University, Bangkok, Thailand
  • Polpichai, Natchaya, Prince of Songkla University, Songkla, Thailand
  • Leelaviwat, Natnicha, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Vutthikraivit, Possawat, Phramongkutklao College of Medicine, Mahidol University, Bangkok, Thailand
Background

Body mass index (BMI) at the time of kidney transplantation (KT) is associated with post-transplant hypertension (HTN). However, imbalance between comparison groups can distort the result.

Methods

Kidney transplant recipients from a single center were divided into obesity and non-obesity with BMI < or≥30 kg/m2, respectively. Baseline pre-transplant characteristics of both groups were balanced by propensity scores (PS) with weighting method leading to new study populations. Association between BMI and post-transplant systolic (SHTN) and diastolic HTN (DHTN) defines as systolic (SBP) and diastolic blood pressure (DBP) of ≥130 and 80 mmHg, respectively at 1.5 year among this new study population was examined by multiple logistic regression.

Results

Of all 70 patients, mean age±SD was 52.7±11 years old, 58.6% were male, and 31% were obese. Mean BMI was significantly higher in obese than non-obese groups (34.1±3.8 vs 24.7±3.4, mean difference 9.4, 95% CI 7.5, 11.3). Several baseline characteristics between 2 groups are different. After using PS weights with generalized boosted modeling to balance covariates (Figure 1), obese group has 7.09 and 9.21 times higher the odds of having SHTN and DHTN, respectively compared to non-obese group (SHTN: OR 7.09; 95% CI 1.19, 42.17; DHTN: OR 9.21; 95% CI 2.13, 39.77). After adjusted for race, age, gender, type of induction immunosuppression, type of KTx, the association remains (SHTN: OR 5.53; 95% CI 4.12, 741.02; DHTN: OR 12.32; 95% CI 2.23, 68.15).

Conclusion

With PS as a balancing method to examine inference, pre-transplant obesity remains one of the risks for post-transplant HTN. Pre-transplant weight should be controlled to mitigate poorer transplant outcomes.