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Journal article
Post-kidney transplant body mass index trajectories are associated with graft loss and mortality
Clinical transplantation, v 37(5), e14947
May 2023
PMID: 36811329
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background : Early post-kidney transplantation (KT) changes in physiology, medications, and health stressors likely impact body mass index (BMI) and likely impact all-cause graft loss and mortality.
Methods : We estimated 5-year post-KT (n = 151 170; SRTR) BMI trajectories using an adjusted mixed effects model. We estimated long-term mortality and graft loss risks by 1-year BMI change quartile (decrease [1st quartile]: change < −.07 kg/m2/month; stable [2nd quartile]: −.07 ≤ change ≤ .09 kg/m2/month; increase [3rd, 4th quartile]: change > .09 kg/m2/month) using adjusted Cox proportional hazards models.
Results : BMI increased in the 3 years post-KT (.64 kg/m2/year, 95% CI: .63, .64) and decreased in years 3–5 (−.24 kg/m2/year, 95% CI: −.26, −.22). 1-year post-KT BMI decrease was associated with elevated risks of all-cause mortality (aHR = 1.13, 95% CI: 1.10–1.16), all-cause graft loss (aHR = 1.13, 95% CI: 1.10–1.15), death-censored graft loss (aHR = 1.15, 95% CI: 1.11–1.19), and mortality with functioning graft (aHR = 1.11, 95% CI: 1.08–1.14). Among recipients with obesity (pre-KT BMI≥30 kg/m2), BMI increase was associated with higher all-cause mortality (aHR = 1.09, 95% CI: 1.05–1.14), all-cause graft loss (aHR = 1.05, 95% CI: 1.01–1.09), and mortality with functioning graft (aHR = 1.10, 95% CI: 1.05–1.15) risks, but not death-censored graft loss risks, relative to stable weight. Among individuals without obesity, BMI increase was associated with lower all-cause graft loss (aHR = .97, 95% CI: .95–.99) and death-censored graft loss (aHR = .93, 95% CI: .90–.96) risks, but not all-cause mortality or mortality with functioning graft risks.
Conclusions : BMI increases in the 3 years post-KT, then decreases in years 3–5. BMI loss in all adult KT recipients and BMI gain in those with obesity should be carefully monitored post-KT.
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Details
- Title
- Post-kidney transplant body mass index trajectories are associated with graft loss and mortality
- Creators
- Yi Liu - Johns Hopkins University School of MedicineVictoria A Bendersky - Johns Hopkins University School of MedicineXiaomeng Chen - Johns Hopkins University School of MedicineNidhi Ghildayal - New York UniversityMeera N Harhay - Drexel University, College of MedicineDorry L Segev - New York UniversityMara McAdams-DeMarco - Johns Hopkins University
- Publication Details
- Clinical transplantation, v 37(5), e14947
- Publisher
- Wiley
- Grant note
- K23 DK105207 / NIDDK NIH HHS R01 DK124388 / NIDDK NIH HHS K24 AI144954 / NIAID NIH HHS R01 AG055781 / NIA NIH HHS R01 DK114074 / NIDDK NIH HHS R01 DK120518 / NIDDK NIH HHS F32 DK124962 / NIDDK NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000943755100001
- Scopus ID
- 2-s2.0-85149593341
- Other Identifier
- 991021861179404721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery
- Transplantation