Weight Loss Tied to Adverse Outcomes in Deceased Donor Kidney Transplant
WEDNESDAY, May 22, 2019 -- Substantial weight loss before deceased donor kidney transplantation (DDKT) is associated with worse outcomes among DDKT recipients, according to a study published online May 21 in the American Journal of Kidney Diseases.
Meera Nair Harhay, M.D., from the Drexel University College of Medicine in Philadelphia, and colleagues conducted a retrospective cohort study for all adult DDKT recipients in the United States between Dec. 4, 2004, and Dec. 3, 2014. The authors examined the correlation between relative pre-DDKT weight change and three outcomes: transplant hospitalization length of stay (LOS), all-cause graft failure, and mortality.
The researchers found a median pre-DDKT weight change of 0 among 94,465 recipients of DDKT. Nonlinear unadjusted associations were identified between relative pre-DDKT weight loss and longer hospitalization LOS, higher graft loss, and higher mortality. Recipients who lost ≥10 percent of their listing weight compared with those with a pre-DDKT weight change <5 percent had an average 0.66 days longer transplant hospitalization LOS and higher graft loss and mortality (adjusted hazard ratios, 1.11 and 1.18, respectively), independent of recipient, donor, and transplant factors.
"Without closely monitoring changes in body composition, 'successful' weight loss in an obese patient could cause a physician to overlook what would otherwise be a warning sign," Harhay said in a statement. "Our work suggests that we need to be cautious when our patients are losing weight, regardless of body mass index."
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Posted: May 2019