Study: eGFR decline after transplant may be worse for patients who gain weight

Issue: August 2024

ByShawn M. Carter

Fact checked byGina Brockenbrough, MA

Key takeaways:

Annual eGFR decline was 2.34 mL/min per 1.73 m² to 3.50 mL/min per 1.73 m² for patients with lower BMIs.
For those whose BMI was below 30 kg/m² at transplant, eGFR declined 1.5 times faster with class I obesity.

PHILADELPHIA — The course of eGFR decline after kidney transplant may be worse for patients who gain weight after surgery, data from the American Transplant Congress show.

“Weight gain after kidney transplant is common,” Teresa Po-Yu Chiang, MD, MPH, of NYU Langone Health, said here. “Roughly one-third of transplant recipients gain at least 10% of their body weight 1 year after receiving a kidney,” and more weight “can lead to kidney injury through direct or indirect mechanisms as oxidative stress, diabetes or hypertension.”

Shutterstock.com — The annual rate of eGFR decline was 2.34 mL/min per 1.73 m2 to 3.50 mL/min per 1.73 m2 for lower BMIs. *Image: Adobe Stock.*

Researchers evaluated 1,511 adults who had a kidney transplant from 2002 to 2023 using the NYU Transplant Data Hub to examine the relationship between post-transplant BMI trajectories, renal outcomes and weight management in patients who received a kidney.

Patients were followed from 6 months post-transplant until graft failure, death or administrative censoring. Researchers analyzed post-kidney transplant BMIs and serum creatinine ratios.

Results showed that eGFR declined at an annual rate of 2.34 mL/min per 1.73 m²to 3.50 mL/min per 1.73 m²when post-transplant BMI was 30 kg/m² or less.

Of patients whose BMI was less than 30 kg/m²at transplant, eGFR declined 1.5 times faster with class I obesity and 4.5 times faster with class II in the single-institution retrospective cohort. In patients with a transplant and BMI of 30 kg/m²or more at transplant, eGFR decline happened 1.7 times faster when having weight loss to a BMI of less than 30 kg/m².

Given these findings, Chiang said, “Weight management should be an essential component of kidney transplant management.”

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Sources/Disclosures

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Source:

Chiang TP, et al. Poster 1082. Presented at: American Transplant Congress; June 1-5, 2024; Philadelphia.

Disclosures: Chiang reports receiving funding from the NIH.

American Transplant Congress

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Study: eGFR decline after transplant may be worse for patients who gain weight

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