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Obesity is Associated With Delayed Graft Function in Kidney Transplant Recipients: A Paired Kidney Analysis
Obesity is increasingly prevalent among candidates for kidney transplantation. Existing studies have shown conflicting post-transplant outcomes for obese patients which may relate to confounding bias from donor-related characteristics that were unaccounted for. We used ANZDATA Registry data to compa...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10261700/ https://www.ncbi.nlm.nih.gov/pubmed/37324221 http://dx.doi.org/10.3389/ti.2023.11107 |
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author | Shi, Bree Ying, Tracey Xu, Josephine Wyburn, Kate Laurence, Jerome Chadban, Steven J |
author_facet | Shi, Bree Ying, Tracey Xu, Josephine Wyburn, Kate Laurence, Jerome Chadban, Steven J |
author_sort | Shi, Bree |
collection | PubMed |
description | Obesity is increasingly prevalent among candidates for kidney transplantation. Existing studies have shown conflicting post-transplant outcomes for obese patients which may relate to confounding bias from donor-related characteristics that were unaccounted for. We used ANZDATA Registry data to compare graft and patient survival between obese (BMI >27.5 kg/m(2) Asians; >30 kg/m(2) non-Asians) and non-obese kidney transplant recipients, while controlling for donor characteristics by comparing recipients of paired kidneys. We selected transplant pairs (2000–2020) where a deceased donor supplied one kidney to an obese candidate and the other to a non-obese candidate. We compared the incidence of delayed graft function (DGF), graft failure and death by multivariable models. We identified 1,522 pairs. Obesity was associated with an increased risk of DGF (aRR = 1.26, 95% CI 1.11–1.44, p < 0.001). Obese recipients were more likely to experience death-censored graft failure (aHR = 1.25, 95% CI 1.05–1.49, p = 0.012), and more likely to die with function (aHR = 1.32, 95% CI 1.15–1.56, p = 0.001), versus non-obese recipients. Long-term patient survival was significantly worse in obese patients with 10- and 15-year survival of 71% and 56% compared to 77% and 63% in non-obese patients. Addressing obesity is an unmet clinical need in kidney transplantation. |
format | Online Article Text |
id | pubmed-10261700 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-102617002023-06-15 Obesity is Associated With Delayed Graft Function in Kidney Transplant Recipients: A Paired Kidney Analysis Shi, Bree Ying, Tracey Xu, Josephine Wyburn, Kate Laurence, Jerome Chadban, Steven J Transpl Int Health Archive Obesity is increasingly prevalent among candidates for kidney transplantation. Existing studies have shown conflicting post-transplant outcomes for obese patients which may relate to confounding bias from donor-related characteristics that were unaccounted for. We used ANZDATA Registry data to compare graft and patient survival between obese (BMI >27.5 kg/m(2) Asians; >30 kg/m(2) non-Asians) and non-obese kidney transplant recipients, while controlling for donor characteristics by comparing recipients of paired kidneys. We selected transplant pairs (2000–2020) where a deceased donor supplied one kidney to an obese candidate and the other to a non-obese candidate. We compared the incidence of delayed graft function (DGF), graft failure and death by multivariable models. We identified 1,522 pairs. Obesity was associated with an increased risk of DGF (aRR = 1.26, 95% CI 1.11–1.44, p < 0.001). Obese recipients were more likely to experience death-censored graft failure (aHR = 1.25, 95% CI 1.05–1.49, p = 0.012), and more likely to die with function (aHR = 1.32, 95% CI 1.15–1.56, p = 0.001), versus non-obese recipients. Long-term patient survival was significantly worse in obese patients with 10- and 15-year survival of 71% and 56% compared to 77% and 63% in non-obese patients. Addressing obesity is an unmet clinical need in kidney transplantation. Frontiers Media S.A. 2023-05-30 /pmc/articles/PMC10261700/ /pubmed/37324221 http://dx.doi.org/10.3389/ti.2023.11107 Text en Copyright © 2023 Shi, Ying, Xu, Wyburn, Laurence and Chadban. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Health Archive Shi, Bree Ying, Tracey Xu, Josephine Wyburn, Kate Laurence, Jerome Chadban, Steven J Obesity is Associated With Delayed Graft Function in Kidney Transplant Recipients: A Paired Kidney Analysis |
title | Obesity is Associated With Delayed Graft Function in Kidney Transplant Recipients: A Paired Kidney Analysis |
title_full | Obesity is Associated With Delayed Graft Function in Kidney Transplant Recipients: A Paired Kidney Analysis |
title_fullStr | Obesity is Associated With Delayed Graft Function in Kidney Transplant Recipients: A Paired Kidney Analysis |
title_full_unstemmed | Obesity is Associated With Delayed Graft Function in Kidney Transplant Recipients: A Paired Kidney Analysis |
title_short | Obesity is Associated With Delayed Graft Function in Kidney Transplant Recipients: A Paired Kidney Analysis |
title_sort | obesity is associated with delayed graft function in kidney transplant recipients: a paired kidney analysis |
topic | Health Archive |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10261700/ https://www.ncbi.nlm.nih.gov/pubmed/37324221 http://dx.doi.org/10.3389/ti.2023.11107 |
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