Coronary events in obese hemodialysis patients before and after renal transplantation.
We examined the impact of obesity (BMI ≥30 kg/m(2) , n = 357) on prognosis in 1696 hemodialysis (HD) patients before and after renal transplantation (TX). End-points were coronary events, composite cardiovascular (CV) events, and death. Obese HD patients were older (55.9 ± 9.2 vs. 54.2 ± 11), had more diabetes (54% vs. 40%), dyslipidemia (49% vs. 30%), altered myocardial scan (38% vs. 31%), myocardial infarction (MI) (16% vs. 10%), coronary intervention (11% vs. 7%), higher total cholesterol (186 ± 52 vs. 169 ± 47), and triglycerides (219 ± 167 vs. 144 ± 91). Obese undergoing TX had more dyslipidemia (46% vs. 31%), angina (23% vs. 14%), MI (18% vs. 5%), increased total cholesterol (185 ± 56 vs. 172 ± 48), and triglycerides (237 ± 190 vs. 149 ± 100). Obesity was independently associated with coronary events (log-rank = 0.008, HR 2.55% CI 1.27-5.11) and death (log-rank 0.046, HR 1.52, % CI 1.007-2.30) in TX but not in HD. Obese HD patients had more risk factors and ischemic heart disease, but these characteristics did not interfere with prognosis. In TX patients, obesity predicts coronary events and death.
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Jose Jayme G
JJ
De Lima
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Luis Henrique W
LH
Gowdak
Renal Transplant Unit, Urology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
Flavio J
FJ
de Paula
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.|Faculty of Medicine, Agostinho Neto University, Luanda, Angola.
Henrique Cotchi S
HC
Muela
Renal Transplant Unit, Urology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
Elias
E
David-Neto
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Luiz A
LA
Bortolotto
D003324:Coronary Artery Disease / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors
chronic kidney disease; hemodialysis; ischemic heart disease; obesity; renal transplantation