title: One-year post-transplant weight gain is a risk factor for graft loss.
abstract: Metabolic syndrome (MS) and obesity participate in the pathogenesis of kidney disease. We explored the impact of MS and post-transplant weight gain on graft survival. Two hundred ninety-two renal transplant recipients (RTRs) were included in the study. Various parameters (e.g. anthropometric, biological) were measured at the time of transplantation as well as 1 year post-transplant. The proportion of patients with overweight or obesity significantly increased during the first year post-transplant (p = 0.04). Mean weight gain was 2.7 +/- 5.8 kg. Thirty patients (10.3%) lost their graft during follow-up. In multivariate analysis, patients with an increase in body mass index (BMI) of more than 5% at 1 year post-transplant had an increased risk of graft loss with (HR: 2.82 [95% CI: 1.11-7.44], p = 0.015) or without death censoring (HR: 2.31 [95% CI: 1.06-5.04], p = 0.035). Low creatinine clearance (HR: 4.72 [95% CI: 1.63-13.69], p = 0.004), high urinary protein excretion (HR: 3.21 [95% CI: 1.27-8.18], p = 0.014) and delayed graft function (DGF) (HR: 2.621 [95% CI: 1.07-6.39], p = 0.036) were also independent risk factors for graft loss. MS did not independently predict graft loss, partly due to significant interactions with low-grade inflammation. We conclude that post-transplant weight gain significantly reduces graft survival.
authors.affiliation: Department of Nephrology and Renal Transplantation, Saint-Jacques Hospital, University of Franche-Comté, Besançon, France. dducloux@chu-besancon.fr
authors.forename: D
authors.initials: D
authors.lastname: Ducloux
authors.forename: A
authors.initials: A
authors.lastname: Kazory
authors.forename: D
authors.initials: D
authors.lastname: Simula-Faivre
authors.forename: J-M
authors.initials: JM
authors.lastname: Chalopin
mesh_terms: D000328:Adult; D003928:Diabetic Nephropathies / Q000453:epidemiology*; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D015430:Weight Gain