Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
There is epidemiologic evidence of an association between elevated body mass index (BMI), the progression of cardiovascular disease (CVD), and end-stage renal disease (ESRD). For patients undergoing kidney transplantation (KT), the associations between BMI, graft failure and mortality remain in conflict. The Japan Academic Consortium of Kidney Transplantation (JACK), established in June 2014, is a multicenter observational cohort study of 3,238 registered KT recipients at seven centers as of December 2014. We evaluated the impact of pretransplant BMI on posttransplant outcomes in patients who underwent living KT (LKT) using this cohort.
We reviewed KT recipients listed in the JACK from three centers who were treated between 2000 and 2013. All patients had undergone LKT at 20 years of age or older. The present study excluded patients if they had received positive complement-dependent cytotoxicity assay (CDC) or flow cytometric crossmatching (FCXM) results. We identified a cohort of 888 recipients, who received standard immunosuppressive therapy. Pretransplant BMI was divided into three categories according to tertile: < 19.4, 19.5–22.2, and ≥ 22.3 kg/m2.
With the second tertile as the referent group in a multivariable time-to-event analysis, estimated hazard ratios of the BMI effects regarding graft failure were 1.62 (95% CI, 0.83–3.18) for the first tertile and 2.20 (95% CI, 1.24–3.90) for the third tertile; patient mortality was 1.21 (95% CI, 0.32–4.54) for the first tertile and 1.52 (95% CI, 0.56–4.13) for the third tertile. In a subgroup analysis, the effects of BMI according to gender were substantially heterogeneous (P = 0.029 for interaction). Pretransplant BMI had a non-linear J-shaped association with graft failure that resulted from qualitative interaction between BMI and the recipient's gender.
Gender differences and interaction effects must be considered when evaluating the effects of pretransplant BMI on posttransplant outcomes for patients undergoing living kidney transplantation.
CITATION INFORMATION: Okumi M, Unagami K, Furusawa M, Hirai T, Okabe Y, Masutani K, Shimizu T, Omoto K, Ishida H, Kitazono T, Tanabe K, The Japan Academic Consortium of Kidney Transplantation (JACK) Association Between Pretransplant Body Mass Index and Outcomes in Patients Undergoing Living Kidney Transplantation: A Consideration of Gender Differences. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Okumi M, Unagami K, Furusawa M, Hirai T, Okabe Y, Masutani K, Shimizu T, Omoto K, Ishida H, Kitazono T, Tanabe K. Association Between Pretransplant Body Mass Index and Outcomes in Patients Undergoing Living Kidney Transplantation: A Consideration of Gender Differences. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/association-between-pretransplant-body-mass-index-and-outcomes-in-patients-undergoing-living-kidney-transplantation-a-consideration-of-gender-differences/. Accessed March 7, 2021.
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