Association of body mass index of kidney transplant recipients with graft function post-transplant
Yaldo A, Bajjoka I, Crombez C, and Abouljoud M. Association of body mass index of kidney transplant recipients with graft function post-transplant. Am J Transplant 2018;18(Suppl 4):541.
Am J Transplant
Purpose: Obese kidney transplant recipients (KTR) are known to have a significantly higher risk of delayed graft function; however, there is no data on patients who have slow graft function (SGF) and do not require dialysis post-transplant. This analysis studies association of BMI and SGF. Methods: A single-center retrospective analysis of medical records of 352 KTR from 2012-15 was performed. Study population was divided into cohorts: immediate (IGF, n=174), slow (SGF, n=83), and delayed (DGF, n=95). IGF is defined as KTR with a serum creatinine (SCr) <3mg/dL; SGF as KTR with a SCr ≥3mg/dL at postoperative day (POD) 5 not requiring dialysis; and DGF as KTR requiring dialysis within the first 7 POD. KTR received antithymocyte globulin (4.5mg/kg), basiliximab (20mg x2), or no induction based on immunological risk. BMI is measured as a continuous variable at the time of transplant. Logistic regression was used to study the association of BMI and graft function (GF) adjusted for age, induction therapy, type of transplant, donor SCr, gender, race, cPRA, transplant hospital LOS, and ICU admission. Follow-up charges ($K) for the first year of transplant and odds ratio are presented. Results: With each 1kg/m2, the odds of IGF (instead of DGF) decrease by 2% (p<0.001), the odds of SGF (instead of IGF) increase by 1% (p<0.05), and the odds of DGF (instead of SGF) increase by 2% (p<0.05). These findings were corroborated by all subgroup analyses. IGF, SGF, and DGF groups were followed for 1062 (664, 1460), 1047 (726, 1368), and 866 (497, 1235), respectively (p>0.05). SCr were higher at FU for SGF than IGF [1.45 (1.18, 1.95); 1.3 (1.01, 1.54); p<0.001]. Overall cost at follow-up was greater for SGF than IGF [227 (201, 256); 193 (165, 248); p<0.001]. (Table Presented) Conclusion: There is a strong relationship between BMI at baseline and graft function post-transplant among KTR. Any modest increase in BMI results in decreased GF and increases in overall medical costs of transplantation. KTR with normal BMI still experience SGF.