In order to study the predictive factors of graft loss, patients were divided into two groups: those who experienced graft loss and those who did not during the study. Obesity
and other commonly associated factors of graft loss were assessed (Table 8). Cox regression analysis was used to study the impact of obesity and other covariates C59 wnt concentration such as age of recipient, pre-transplant DM, post-transplant DM, human leucocyte antigen mismatch and history of acute rejection on graft outcome. Obesity (odds ratio (OR) = 3.09), acute rejection (OR = 5.68), pre-transplant DM (OR = 3.21) and age of recipient (OR = 1.06) were all significant independent risk factors associated with development of graft failure (Table 9). Because DGF was more common in the obese group (33.3% vs 15%), the effect of obesity on graft survival might be related to a higher incidence of DGF. However, the results of each individual predictive factor remained unaffected even selleck chemicals if DGF was introduced in the multivariate analysis. Obesity is an established risk factor of cardiovascular disease and is
associated with increased mortality in the general population.17 Many survival studies in haemodialysis patients, however, have shown the ‘reverse epidemiology’, namely, low values of BMI are associated with increased mortality, whereas higher values of BMI are associated with improved survival in dialysis patients.18,19 On the other hand, the published work analyzing the impact of obesity in renal transplant recipients had conflicting results.3–5,20–22 In our population, with a median follow-up period of 73 months, there was a significant association between obesity and graft loss or mortality after transplant. This is in accordance with the results of the study by Chow et al.10 However, it would be necessary to study the impact of BMI on the survival rates of our dialysis patients before excluding obese patients from kidney transplant, because the overall patient
outcome could be even worse if obesity had a larger impact on survival for those who maintained on dialysis than those who underwent kidney transplant. ASK1 Obesity is a significant risk factor of coronary artery disease in patients on chronic haemodialysis (relative risk = 5.09).23 Moreover, it is also associated with increased risk for development of post-transplant DM, hypertension and hyperlipidaemia which, like in the general population, are risk factors for cardiovascular mortality and morbidity after kidney transplant. Modlin et al. demonstrated that there was a greater incidence of post-transplant DM in obese renal transplant recipients when compared with matched non-obese recipients (12% vs 2%) and that cardiac diseases are the leading cause of deaths (39.1%) in obese patients.
Related posts:
- Late referral and lack of dialysis access are independent predict
- A smaller study (N = 39) by the same group reported no difference
- [10, 11, 18, 19] Death with functioning graft due to infections i
- 0%, 0 0%, and 11 6%, respectively) than that in the present study
- In order to demonstrate that loss of protective effects of partic