Are Females More Prone Than Males to Become Obese After Kidney Transplantation?

Katarzyna Hap, Katarzyna Madziarska, Wojciech Hap, Sławomir Zmonarski, Dorota Zielińska, Dorota Kamińska, Mirosław Banasik, Katarzyna Kościelska-Kasprzak, Marian Klinger, Oktawia Mazanowska, Katarzyna Hap, Katarzyna Madziarska, Wojciech Hap, Sławomir Zmonarski, Dorota Zielińska, Dorota Kamińska, Mirosław Banasik, Katarzyna Kościelska-Kasprzak, Marian Klinger, Oktawia Mazanowska

Abstract

<strong>BACKGROUND</strong> Being overweight for kidney transplant recipients can cause serious side effects. Weight gain affects two-thirds of kidney transplant recipients and has been attributed to a more liberal diet after transplantation, recovery of appetite due to lack of uremic toxicity, corticosteroid use, and inadequate lifestyle changes. The aim of this study was to assess gender-dependent profile of body mass index (BMI) changes after kidney transplantation (KTx). <strong>MATERIAL AND METHODS</strong> Sixty-two kidney transplant recipients (38 males and 24 females), aged 46.0±12.8 years at KTx, were observed according to weight gain after KTx. BMI was calculated before transplantation (pre-KTx) and at 6, 12, and 24 months post-KTx. <strong>RESULTS</strong> During the 24-month observation period, we found an increase in the incidence of kidney transplant recipients being overweight or obese (pre-KTx 43.5% increase and 24-month post-Ktx 61.3% increase, P=0.036). We analyzed a number of factors that could potentially influence a 24-month BMI gain including age at KTx, gender, pre-KTx BMI, time on dialysis, pre-KTx glucose metabolism disorder, and post-KTx diabetes mellitus. For female recipients, there was a significant step-wise post-KTx increase in BMI during the 24-month observation period. The overall pre-KTx to 24-month net increase for female BMI was 2 times greater than that observed for male recipients (1.90±2.20 kg/m² versus 0.89±1.85 kg/m², P<0.001). <strong>CONCLUSIONS</strong> Weight gain after KTx was observed in both sexes, but the net BMI increase was more than 2 times greater in females than in males at 24-months post-KTx. This indicated the need for diet education and strict weight control in kidney transplant recipients, especially in female patients.

References

    1. Costa B, Moratelli L, Silva LB, et al. Body mass index in the first year after kidney transplantation. Transplant Proc. 2014;46(6):1750–52.
    1. Fernandes JF, Leal PM, Rioja S, et al. Adiposity and cardiovascular disease risk factors in renal transplant recipients: Are there differences between sexes? Nutrition. 2013;29(10):1231–36.
    1. Lentine KL, Delos Santos R, Axelrod D, et al. Obesity and kidney transplant candidates: How big is too big for transplantation? Am J Nephrol. 2012;36:575–86.
    1. Friedman AN, Miskulin DC, Rosenberg IH, et al. Demographics and trends in overweight and obesity in patients at time of kidney transplantation. Am J Kidney Dis. 2003;41:480–87.
    1. Yach D, Stuckler D, Brownell KD. Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nat Med. 2006;12:62–66.
    1. Jaggers HJ, Allman MA, Chan M. Changes in clinical profile and dietary considerations after renal transplantation. J Ren Nutr. 1996;6(1):12–20.
    1. Johnson CP, Gallagher-Lepak S, Zhu YR, et al. Factors influencing weight gain after renal transplantation. Transplantation. 1993;56(4):822–26.
    1. Teplan V, Poledne R, Schück O, et al. Hyperlipidemia and obesity after renal transplantation. Ann Transplant. 2001;6(2):21–23.
    1. Moore LW, Gaber AO. Patterns of early weight change after renal transplantation. J Ren Nutr. 1996;6(1):21–25.
    1. Orazio L, Chapman J, Isbel NM, Campbell KL. Nutrition care for renal transplant recipients: An evaluation of service delivery and outcomes. J Ren Care. 2014;40(2):99–106.
    1. Ryan KJ, Segedin JM, Mash LE, et al. The effect of intensive nutrition interventions on weight gain after kidney transplantation: Protocol of a randomized controlled trial. BMC Nephrol. 2014;15:148.
    1. Heinbokel T, Floerchinger B, Schmiderer A, et al. Obesity and its impact on transplantation and alloimmunity. Transplantation. 2013;96(1):10–16.
    1. Orazio L, Hickman I, Armstrong K, et al. Higher levels of physical activity are associated with a lower risk of abnormal glucose tolerance in renal transplant recipients. J Ren Nutr. 2009;19(4):304–13.
    1. Nielens H, Lejeune TM, Lalaoui A, et al. Increase of physical activity level after successful renal transplantation: A 5year follow-up study. Nephrol Dial Transplant. 2001;16(1):134–40.
    1. Zelle DM, Kok T, Dontje ML, et al. The role of diet and physical activity in post-transplant weight gain after renal transplantation. Clin Transplant. 2013;27(4):E484–90.
    1. Hill CJ, Cardwell CR, Maxwell AP, et al. Obesity and kidney disease in type 1 and 2 diabetes: An analysis of the National Diabetes Audit. QJM. 2013;106:933–42.
    1. Luk AOY, So WY, Ma RCW, et al. Metabolic syndrome predicts new onset of chronic kidney disease in 5,829 patients with type 2 diabetes – a 5-year prospective analysis of the Hong Kong Diabetes Registry. Diabetes Care. 2008;31:2357–61.
    1. Massy ZA, Kasiske BL. Post-transplant hyperlipidemia: Mechanisms and management. J Am Soc Nephrol. 1996;7:971–77.
    1. Aakhus S, Dahl K, Wideroe TE. Cardiovascular morbidity and risk factors in renal transplant patients. Nephrol Dial Transplant. 1999;14:648–54.
    1. Chakkeraa HA, Weil EJ, Pham PT, et al. Can new onset diabetes after kidney transplant be prevent? Diabetes Care. 2013;36:1406–12.
    1. Jindal RM, Sidner RA, Milgrom ML. Post-transplant diabetes mellitus. The role of immunosuppression. Drug Saf. 1997;16:242–57.
    1. Weir MR, Fink JC. Risk for post-transplant diabetes mellitus with current immunosuppressive medications. Am J Kidney Dis. 1999;34:1–13.
    1. Hap K, Madziarska K, Zmonarski S, et al. Pre-transplantation oral glucose tolerance test can prevent post-transplant diabetes mellitus after renal transplantation; Preliminary study. Transplant Proc. 2018;50:1776–80.
    1. McDonald SP, Russ GR. Survival of recipients of cadaveric kidney transplants compared with those receiving dialysis treatment in Australia and New Zealand, 1991–2001. Nephrol Dial Transplant. 2002;17(12):2212–19.
    1. Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341(23):1725–30.
    1. Laupacis A, Keown PNP, Krueger H, et al. A study of the quality of life and cost-utility of renal transplantation. Kidney Int. 1996;50:235–42.
    1. Howard K, Salkeld G, White S, et al. The cost-effectiveness of increasing kidney transplantation and home-based dialysis. Nephrology. 2009;14(1):123–32.
    1. Haller M, Gutjahr G, Kramar R, et al. Cost-effectiveness analysis of renal replacement therapy in Austria. Nephrol Dial Transplant. 2011;26(9):2988–95.
    1. van Walraven C, Manuel DG, Knoll G. Survival trends in ESRD patients compared with the general population in the United States. Am J Kidney Dis. 2013;63(3):491–99.
    1. Nicoletto BB, Fonseca NK, Manfro RC, et al. Effects of obesity on kidney transplantation outcomes: A systematic review and meta-analysis. Transplantation. 2014;98(2):167–76.
    1. Gętek M, Nowakowska-Zajdel E, Czech N, et al. Quality of life of patients on dialysis and after renal transplantation. Ann Acad Med Siles. 2010;64:23–30.
    1. Klaassen G, Zelle DM, Navis GJ, et al. Lifestyle intervention to improve quality of life and prevent weight gain after renal transplantation: Design of the active care after transplantation (ACT) randomized controlled trial. BMC Nephrol. 2017;18(1):296.

Source: PubMed

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