מתוך אתר medicontext.co.il WESTPORT, CT (Reuters Health) – One year after renal transplantation, patients who are poor, female, and young are more likely to gain weight, researchers from the University of Alabama at Birmingham report in the August issue of the American Journal of Kidney Diseases. Race and no episodes of rejection were also associated with weight gain.
"Previous studies of renal transplant patients have suggested that weight gain after transplantation is relatively common, especially among certain populations," Dr. Jeannine M. Clunk and colleagues explain. To further investigate, they retrospectively studied 974 renal transplant patients.
They found that 1 year after transplantation the average weight gain was 10.3 kg. In patients for whom data were available after 2 years, the average weight gain was 1.7 kg. However, in the third year there was an average weight loss of 0.2 kg.
The results of multivariant analysis revealed a significant correlation between weight gain and female sex, low income level, and younger age. Dr. Clunk's group also found that the "incidence rejection was inversely related to weight."
Black race was also associated with weight gain in univariate analysis, but this relationship "decreased in significance after sex and income were factored into the analyses."
"Unfortunately, Clunk et al. did not correlate posttransplant weight gain with outcomes such as acute rejection or graft survival," Dr. Donald E. Hricik from University Hospitals of Cleveland comments in a journal editorial.
"The emerging profile of the patient at risk for posttransplant weight gain (i.e., the poor, young black woman) is strikingly similar to the profile of patients at high risk for acute rejection and graft loss, suggesting that weight gain/obesity somehow influences the immunologic response to an allograft," Dr. Hricik notes.
Further study to clarify these relationships is needed. In the meantime, he recommends the subgroup of patients with these characteristics "be targets for aggressive intervention measures designed to prevent" posttransplant weight gain.
Am J Kidney Dis 2001;38:349-353,409-410.
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