Document Detail


Body mass index and allograft function in pediatric renal transplantation.
MedLine Citation:
PMID:  12172770     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent studies indicate that pre-transplant (Tx) obesity and increased body mass index (BMI) after renal Tx in adults are associated with decreased long-term renal allograft survival. This study examined whether obesity prior to renal Tx or the development of obesity within the 1st year after Tx in children is associated with worse allograft function at 1 year post Tx. This is a retrospective review of medical records from 76 pediatric renal allograft recipients between January 1994 and December 2000. Recipients had their renal allograft functioning at 1 year, and had a glomerular filtration rate (GFR) measured 1 year post Tx. Obesity was defined as body mass index (BMI)> or =95th percentile for age, sex, and race. Patients were divided into three groups: (1) children who had BMI> or =95th percentile at time of Tx, (2) children who had BMI<95th percentile at time of Tx but became obese at 1 year after Tx, and (3) children with BMI<95th percentile at time of Tx and 1 year later. The number of patients with BMI> or =95th percentile doubled at 1 year after Tx when compared with pre-Tx data: 10 (13%) versus 22 (29%), respectively. Fifteen (20%) patients developed obesity and 10 (13%) patients had BMI between the 85th and 95th percentile at 1 year post Tx. Children in group 1 had significantly lower mean GFR (46.1+/-15.0 ml/min per 1.73 m(2)) than children in group 2 (57.7+/-24.5 ml/min per 1.73 m(2), P<0.05) and group 3 (60.4+/-21.5 ml/min per 1.73 m(2), P<0.01). The difference remained significant after adjusting GFR to height: group 1 24.0+/-5.2 ml/min per m, group 2 31.5+/-11.2 ml/min per m, P<0.05, and group 3 32.2+/-10.6 ml/min per m, P<0.01. Children with pre-Tx obesity (group 1) had significantly higher indexed systolic blood pressure ( P<0.01) than children from other groups. We conclude that pre-Tx obesity is associated with decreased GFR in children at 1 year after Tx. The reason may be persistence or development of post-Tx hypertension in severely obese patients.
Authors:
Mark M Mitsnefes; Philip Khoury; Paul T McEnery
Publication Detail:
Type:  Journal Article     Date:  2002-05-17
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  17     ISSN:  0931-041X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-08-12     Completed Date:  2003-02-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  535-9     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Department of Pediatrics, University of Cincinnati College of Medicine and The Children's Hospital Research Foundation TCHRF-5, Ohio 45229-3039, USA. Mark.Mitsnefes@chmcc.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Body Mass Index*
Child
Child, Preschool
Female
Glomerular Filtration Rate
Humans
Hypertension, Renal / etiology
Infant
Kidney / physiology
Kidney Transplantation*
Male
Obesity / complications,  diagnosis*
Retrospective Studies
Transplantation, Homologous

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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