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Abstract: PO2528

Post-Transplant Outcomes Among Kidney Transplant Recipients with Intentional and Unintentional Weight Loss

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Harhay, Meera Nair, Drexel University, Philadelphia, Pennsylvania, United States
  • Chen, Xiaomeng, Johns Hopkins University, Baltimore, Maryland, United States
  • Chu, Nadia M., Johns Hopkins University, Baltimore, Maryland, United States
  • McAdams-DeMarco, Mara, Johns Hopkins University, Baltimore, Maryland, United States
Background

Research has shown that kidney transplant (KT) recipients who lose weight before KT are at increased risk for post-KT weight gain, all-cause graft loss (ACGL), and mortality. No studies have examined whether these associations differ between KT recipients with intentional and unintentional weight loss.

Methods

Among 366 KT recipients from a prospective cohort study of frailty and KT, we used adjusted mixed effects models to estimate differences in post-KT BMI trajectories, ACGL, and mortality by 1-year pre-KT weight change, defined as stable weight, intentional weight loss, unintentional weight loss, and weight gain.

Results

Mean age was 53 years, 39% were black, and 39% were female. The majority (64%) had stable pre-KT weight, 12% had weight gain, 14% had unintentional weight loss, and 10% had intentional weight loss. By 3 years post-KT, BMI increased by 0.05 kg/m2 (95% CI 0.02, 0.08 kg/m2) among those with stable pre-KT weight; the increase was similar among those with pre-KT weight gain and intentional weight loss. Those with pre-KT unintentional weight loss had larger increases in post-KT BMI than those with stable weight (BMI change difference +0.15 kg/m2 [0.04, 0.25 kg/m2], p=0.01). Unadjusted cumulative incidence of mortality was similar across weight change categories (Figure). Adjusted for age, sex, race, BMI, and donor type, only unintentional weight loss was associated with higher mortality (aHR 2.31 [1.24,4.31], p=0.008) and ACGL (aHR 2.02 [1.24,3.31], p=0.005) relative to stable weight.

Conclusion

In this study, pre-KT unintentional weight loss was associated with higher post-KT BMI increases, ACGL and mortality than pre-KT intentional weight loss, stable weight, and weight gain . These results suggest that unintentional weight loss should be identified and addressed in KT candidates, independent of BMI.

Cumulative Incidence of Mortality among Kidney Transplant Recipients by Pre-Transplant Weight Change

Funding

  • NIDDK Support