Long-Term Effect of Body Mass Index Changes on Graft Damage Markers in Patients After Kidney Transplantation

Kurnatowska, Ilona; Małyska, Aneta; Wysocka, Kamila; Mazur, Katarzyna; Krawczyk, Joanna; Nowicki, Michał

doi:10.12659/aot.899393

Cited by 11 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This can be explained by the poor nutritional status of patients on prolonged dialysis periods as they need longer recovery time post-transplantation. A study in Poland reported that BMI was increased in almost 65% of kidney recipients, and the weight gain was higher in patients with normal BMI pre-transplantation compared to those classified as overweight or obese [ 22 ]. Additionally, our findings did not show that females were at higher risk to gain weight, unlike other reported studies that have estimated their risk to be up to two times higher than males [ 16 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Weight gain after renal transplant: Incidence, risk factors, and outcomes

et al. 2022

View full text Add to dashboard Cite

Background Renal transplantation is the definitive treatment for patients with end-stage renal disease (ESRD). It is associated with better quality of life and patient survival. Nevertheless, these benefits come with rising concerns about weight gain and metabolic abnormalities, which adversely impact transplant outcomes. Objective The objective of this study is to estimate the incidence of weight gain in the first year post-renal transplant in addition to the assessment of potential risk factors and the resulting outcome of the graft. Methods We conducted a single-center retrospective cohort study of all 295 patients who underwent kidney transplantation at King Abdulaziz Medical City (KAMC) between January 2016 and December 2019. Clinical and laboratory variables were collected from electronic records. Continuous variables were reported as mean ± standard deviation. Comparison between groups was assessed by unpaired t-test or Mann-Whitney U test while follow-up data were compared using paired t-test and repeated measures ANOVA. Association between the potential risk factors and the weight gain was assessed by means of binary logistic regression analysis. Results Significant weight gain was observed in 161 (54.6%) patients. Females were 119 (40.30%) of the cohort. The mean age was 45.3±15.1 years. The prevalence of diabetes was 234 (79.6%), while hypertensives constituted 77 (26.3%). The comparison between patients who gained weight significantly and patients with stable weight showed a numerical higher prevalence of female gender in patients who had more weight gain (44.1% vs. 35.8%), higher diabetes, higher rate of a living donor, and statistically significant lower dialysis duration before transplant. Other clinical and laboratory variables were comparable between the two groups. Conclusion Our study showed a high incidence of clinically significant weight gain among patients post-renal transplantation. Patients with lower dialysis duration, a living kidney donor and those who are obese at baseline were at higher risk of gaining weight. Patients who underwent kidney transplantation should be monitored closely for weight gain and further studies are needed to determine the risk factors and appropriate interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Weight gain after renal transplant: Incidence, risk factors, and outcomes

et al. 2022

View full text Add to dashboard Cite

show abstract

“…A study by Kurnatowska et al reported that during the first 3 years following KTx, 65% of patients gained weight, with a mean BMI increase in whole study population of 0.4 6 1.3 kg/m 2 per year. 44 According to a 2015 survey study from another Polish center, 33.9% patients reported weight gain following KTx. 45 Since most HD patients have a small amount of residual diuresis, they are recommended to limit their daily fluid intake.…”

Section: Discussionmentioning

confidence: 99%

Adherence to Pharmacotherapy and Lifestyle Recommendations Among Hemodialyzed Patients and Kidney Transplant Recipients

Nowicka

Górska

Nowicka

et al. 2021

Journal of Renal Nutrition

Self Cite

View full text Add to dashboard Cite

Objective: Success in treatment with hemodialysis (HD) and kidney transplantation (KTx) requires good adherence. The objective of this study was to evaluate adherence to pharmacotherapy and health recommendations among HD and KTx patients using subjective and objective measures.Methods: Two hundred thirty-nine enrolled patients, with 132 KTx (39F, 93M) and 107 HD (48F, 59M) completed a questionnaire regarding over-the-counter (OTC) medications and dietary supplements (DS), adherence to pharmacotherapy, lifestyle recommendations, and self-evaluation of knowledge on them. The surveys were supplemented with objective data from patients' medical records, including interdialytic weight gain and laboratory parameters.Results: About 42.1% HD and 39.4% KTx patients reported using OTC medications without medical consultation (P 5 .677); 43.9% HD and 31.1% KTx used DS (P 5 .040); more HD than KTx failed to notify a doctor about it (52.2% vs. 21.4%; P , .001). More HD patients skipped medication doses (33.6% vs. 9.7%; P , .001). About 40.2% HD and 20.5% KTx patients drank alcohol (P , .001), 22.4% HD and 10.5% KTx smoked (P 5 .013). About 46.7% HD and 66.4% KTx patients limited their caloric intake (P 5 .002), 73.8% HD and 84.9% KTx limited their salt intake (P 5 .030). HD patients drank 1.17 6 0.57 L of fluids daily and KTx drank 2.51 6 0.67 L (P , .001). In HD patients, interdialytic weight gains positively correlated with dialysis vintage (R 5 0.26, P 5 .02) and fluid (R 5 0.28, P 5 .011) but not salt intake (P 5 .307). The variability of trough levels of calcineurin inhibitors was unrelated to use of DS or OTC medications. KTx rated their knowledge on recommendations higher compared with HD (mean score 4.0 6 1.0 vs. 3.7 6 1.0, P 5 .040).Conclusion: KTx recipients exhibit better adherence and rate their knowledge on recommendations higher than HD patients.

show abstract

“…Taking into account factors such as age, body weight, BMI, and functional parameters of the kidneys and liver, we can conclude that these values did not affect the dosage of CsA. In addition, it has been shown that changes in some parameters are independent on the type of immunosuppressant used [24].…”

Section: Discusionmentioning

confidence: 93%

Effect of Multidrug-Resistant 1 (MDR1) and CYP3A4*1B Polymorphisms on Cyclosporine-Based Immunosuppressive Therapy in Renal Transplant Patients

et al. 2019

View full text Add to dashboard Cite

Background Immunosuppressive drugs such as cyclosporine A (CsA) are characterized by a narrow therapeutic range and high interindividual pharmacokinetic variations. Therefore, the effective monitoring of drug serum level is crucial for successful therapy. This variability can be caused by polymorphisms in genes encoding drug transporters and enzymes responsible for biotransformation. The aim of this study was to determine the relationship between CYP3A4*1B and MDR1 polymorphisms and dose requirements to achieve the target therapeutic range for CsA. Material/Method The study group consisted of 184 patients after kidney transplantation who were treated with immunosuppressive therapy. The MDR1 3435C>T and CYP3A4*1B polymorphisms were determined by the real-time PCR using the LightCycler ® 480 device (Roche Diagnostics). Results Patients with the CYP3A4*1/*1 genotype received the lowest mean dose of CsA compared to CYP3A4*1/*1B, and had a higher average drug concentration in the blood. In the case of MDR1 3435C>T polymorphism, we observed that patients with the CC genotype received lower doses of CsA than patients with the CT and TT genotypes. Average drug concentration in the blood was comparable to individuals with different MDR-1 genotypes. Analysis of dependence between both polymorphisms and concentration/dose ratio showed no statistically significant differences. Conclusions The characterization of CYP3A4*1B and 3435C>T MDR1 polymorphism cannot provide useful guidance for individualizing CsA dosages in renal transplant patients by indicating the optimal dose of these drugs without exposing patients to possible adverse effects associated mainly with nephrotoxicity.

show abstract

Long-Term Effect of Body Mass Index Changes on Graft Damage Markers in Patients After Kidney Transplantation

Cited by 11 publications

References 0 publications

Weight gain after renal transplant: Incidence, risk factors, and outcomes

Weight gain after renal transplant: Incidence, risk factors, and outcomes

Adherence to Pharmacotherapy and Lifestyle Recommendations Among Hemodialyzed Patients and Kidney Transplant Recipients

Effect of Multidrug-Resistant 1 (MDR1) and CYP3A4*1B Polymorphisms on Cyclosporine-Based Immunosuppressive Therapy in Renal Transplant Patients

Contact Info

Product

Resources

About