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Effect of Changes in Body Mass Index on Cardiovascular Outcomes in Kidney Transplant Recipients

Authors
 K Y Kim  ;  J-H Cho  ;  H-Y Jung  ;  J-Y Choi  ;  S-H Park  ;  C-D Kim  ;  Y-L Kim  ;  H Ro  ;  S Lee  ;  S-Y Han  ;  C W Jung  ;  J B Park  ;  M S Kim  ;  J Yang  ;  C Ahn  ;  KNOW-KT Study Group 
Citation
 TRANSPLANTATION PROCEEDINGS, Vol.49(5) : 1038-1042, 2017-06 
Journal Title
TRANSPLANTATION PROCEEDINGS
ISSN
 0041-1345 
Issue Date
2017-06
MeSH
Adult ; Body Mass Index* ; Cardiovascular Diseases / blood ; Cardiovascular Diseases / mortality ; Cardiovascular Diseases / physiopathology* ; Cohort Studies ; Female ; Glycated Hemoglobin / analysis ; Graft Rejection / blood ; Graft Rejection / mortality ; Graft Rejection / physiopathology* ; Humans ; Kidney Transplantation / mortality* ; Lipoproteins, HDL / blood ; Male ; Middle Aged ; Postoperative Period ; Risk Factors ; Time Factors ; Triglycerides / blood
Abstract
Background: A higher body mass index (BMI) before kidney transplantation (KT) is associated with increased mortality and allograft loss in kidney transplant recipients (KTRs). However, the effect of changes in BMI after KT on these outcomes remains uncertain. The aim of this study was to investigate the effect of baseline BMI and changes in BMI on clinical outcomes in KTRs.

Methods: A total of 869 KTRs were enrolled from a multicenter observational cohort study from 2012 to 2015. Patients were divided into low and high BMI groups before KT based on a BMI cutoff point of 23 kg/m2. Differences in acute rejection and cardiovascular disease (CVD) between the 2 groups were analyzed. In addition, clinical outcomes across the 4 BMI groups divided by BMI change 1 year after KT were compared. Associations between BMI change and laboratory findings were also evaluated.

Results: Patients with a higher BMI before KT showed significantly increased CVD after KT (P = .027) compared with patients with a lower BMI. However, among the KTRs with a higher baseline BMI, only persistently higher BMI was associated with increased CVD during the follow-up period (P = .003). Patients with persistently higher BMI had significantly decreased high-density lipoprotein cholesterol and increased hemoglobin, triglyceride, and hemoglobin A1c levels. Baseline BMI and post-transplantation change in BMI were not related to acute rejection in KTRs.

Conclusions: BMI in the 1st year after KT as well as baseline BMI were associated with CVD in KTRs. More careful monitoring of obese KTRs who do not undergo a reduction in BMI after KT is required.
Full Text
https://www.sciencedirect.com/science/article/pii/S0041134517302695
DOI
10.1016/j.transproceed.2017.03.049
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Sung(김민성)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195904
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