WEIGHT - CARE :WEIGHT EVALUATION IN GRAFT HEALTH AND TRANSPLANTATION - COMPREHENSIVE ANALYSIS OF RISK ELEMENTS
Introduction:
The WEIGHT-CARE study investigates the correlation between post-transplant weight change and survival outcomes in renal transplant patients. Given the global rise in obesity and its links to cardiovascular diseases, diabetes, and hypertension, the study examines how these factors impact long-term survival. Conducted at a tertiary care center in South India, this is the largest study of its kind, tracking weight changes and survival over a decade.
Methods:
Materials and Methods
Aim: To analyze the relationship between weight change and survival outcomes in renal transplant recipients over 10 years.
Objectives:
Investigate the prevalence of weight change in renal transplant recipients and its impact on survival.
Identify factors influencing weight loss/gain in these patients.
Subjects: The study included 716 kidney transplant patients (560 males, 156 females) aged 18-67 years. The inclusion criteria were patients with at least 12 months of follow-up and no retransplant. Patients younger than 18 years at the time of transplant or with a follow-up of less than 12 months were excluded.
Data Collection: Data were collected from transplant files and electronic medical records.
Significant Weight Gain/Loss was defined as >5% change from baseline dry weight at time of transplant
Results:
Results
-Study Population: Out of 794 patients who underwent kidney transplants between January 2009 and December 2018, 716 met the study's inclusion criteria.
-Baseline Characteristics: At the time of transplant, the cohort had a median age of 34 years, with 91.9% suffering from hypertension and 11% from diabetes. The majority (85.6%) were on hemodialysis before transplant, and 89.9% received grafts from living donors. The median BMI was 21.16 kg/m².
-Immunosuppression: Basiliximab induction therapy was used in 72.5% of patients, with the majority receiving Prednisolone, Tacrolimus, and Mycophenolate Mofetil as primary immunosuppression.
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Weight Change at 1 Year and last follow-up(Table 1)
Factors Affecting Significant Weight Gain(Multiple logistic regression rable attached)
· Age: Younger patients more likely to gain weight (OR = 0.97, p = 0.002)
· Gender: Female patients had higher odds of significant weight gain.\
· Baseline Obesity: Strong predictor of further weight gain.
o Overweight patients: OR = 3.76 (p < 0.001).
o Obese patients: OR = 8.37 (p = 0.003).
· CMV Viremia: Lower likelihood of weight gain (OR = 0.52, p = 0.006).
Factors Affecting Significant Weight loss
Recipient Age: 2.4% increased odds of weight loss per year.
Pre-Transplant Hypertension: Lower likelihood of weight loss (odds ratio 0.467).
Post-Transplant Hypertension: Reduced odds of weight loss (odds ratio 0.514).
Post-Transplant CMV Viremia: 2.3 times higher odds of weight loss.
Patient and Graft Outcome
Significant weight gain at 1 year and last follow-up was associated with longer graft survival, with highly significant differences observed at the last follow-up (p < 0.001).
Conversely, significant weight loss at the last follow-up correlated with shorter graft survival (p < 0.001). Patient survival followed a similar pattern: weight gain improved survival, while weight loss, particularly at the last follow-up, decreased it.
Conclusions:
The study highlights the significant prevalence of weight gain among renal transplant recipients, with younger age, female gender, and baseline obesity being key predictors of weight gain. The findings underscore the need for targeted weight management strategies to improve long-term survival outcomes in renal transplant patient Contrary to common assumptions that weight gain post-transplant may negatively impact health, our study reveals that significant weight gain is actually associated with improved graft survival and patient outcomes
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.