Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Poor nutritional parameters in patients with ESRD on hemodialysis are associated with increased rates of hospitalization. The impact of malnutrition and inflammation and poor control of bone-mineral density (BMD) parameters during dialysis immediately post-transplant is unclear.
*Methods: We performed a single-center retrospective analysis of metabolic parameters pre-transplant on post-transplant outcomes in 101 consecutive renal transplant recipients from April 2015 to October 2018 for whom pre-transplant dialysis data was available.
*Results: In the month before transplant, average albumin was 3.95 +/- 0.32, phosphorus 6.08 +/- 1.47, parathyroid hormone (PTH) 775.70 +/- 926.76, and ferritin 700 +/- 404.44. Increased PTH, phosphorus, and the use of intravenous iron were significantly and independently associated with increased serum creatinine at discharge post-transplant (p=0.005, p=0.02, p=0.04 respectively). Higher doses of zemplar pre-transplant were independently associated with longer post-transplant length of stay (p=0.003). Low serum albumin in the month preceding transplant was independently associated with increased readmissions within 90 days. Decreasing serum albumin levels in the three months prior to transplant were independently associated with wound complications post-transplant (p=0.04). Pre-transplant calcium phosphorus product, hemoglobin, ferritin, and dose of erythropoietin stimulating agent did not correlate with serum creatinine at discharge, length of stay, wound complications, nor readmissions at 90 days.
*Conclusions: Poor nutritional and BMD parameters preceding kidney transplant are associated with post-transplant complications and longer hospitalization. Optimization of nutritional status and BMD parameters in patients on dialysis immediately prior to transplant may improve post-transplant outcomes.
To cite this abstract in AMA style:Padiyar A, Agrawal A, Hricik D, Kerner J, Benavides J, Sarabu N, Jittirat A, Yadav K, Sanchez E, DeBroy M, Humphreville V, Rabets J, Palanisamy A, Chavin K. Poor Nutritional And Bone-mineral Density Parameters Pretransplant Predict Complications Posttransplant [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/poor-nutritional-and-bone-mineral-density-parameters-pretransplant-predict-complications-posttransplant/. Accessed March 5, 2021.
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