Renal transplantation
Immunosuppression
Effect of Obesity and Overweight on Cyclosporine Blood Levels and Renal Functions in Renal Adolescent Recipients

https://doi.org/10.1016/j.transproceed.2005.12.054Get rights and content

Abstract

Introduction

The impact of obesity, a frequent problem after renal transplantation, which has been associated with poor graft and patient survival, was evaluated on renal function and cyclosporine (CsA) blood levels.

Patients

We retrospectively evaluated the data of adolescent renal recipients between 1994 and 2004. Patients with serum creatinine ≥ 2.5 mg/dL were excluded. We grouped the data with regard to the body mass index (BMI) percentiles as group I (BMI > 95th), group II (BMI < 95th), group III (BMI > 85th), group IV (BMI < 85th). We compared the clinical and laboratory findings between groups I and II and between groups III and IV.

Results

We evaluated 778 visits of 27 patients (M/F: 19/8). There were 30 visits in the obesity period (group I) and 72 visits after the overweight periods were added (group III). Serum creatinine levels were significantly higher and glomerular filtration rate levels significantly lower among obese and/or overweight than lean periods (P < .05). Proteinuria levels were similar in groups I and II, but significantly higher in group III than group IV (P = .356 and .000, respectively). CsAmg/bw, CsAmg/bmi, and CsAmg/bsa levels were significantly lower in group I than group II and in group III than group IV (P < .05), while C0 and C2 levels were similar (P > .05).

Conclusion

Weight gain is associated with worse renal functions but not greater proteinuria in our patients. Smaller CsA doses were sufficient to maintain C0 and C2 levels similar to the lean patients, results that were parallel to those of adult renal recipients.

Section snippets

Patients and methods

We retrospectively evaluated the data of adolescent renal transplant recipients followed between 1994 and 2004. There were 778 visits of 27 patients meeting our criteria. Eight patients were female (M/F: 19/8) and 19 patients received living related donor transplantations (70%). The mean age at transplantation was 15.25 ± 3.50 (8 to 22) years and the mean duration of follow-up was 60.74 ± 34.68 (5 to 137) months. Patients with chronic allograft nephropathy (serum creatinine ≥ 2.5 mg/dL) were

Results

The number of data recorded in the obese period was 30 (3.9%; group I) and when the overweight periods were added, the number reached 72 (9.3%; group III). Scr levels were significantly higher and GFR levels significantly lower among obese and/or overweight than lean periods (Table 1). Proteinuria was similar in groups I and II, while significantly higher in group III than group IV (P .356 and .000, respectively). CsAmg/bw, CsAmg/bmi, and CsAmg/bsa levels were significantly lower in group I

Discussion

The rate of obesity in children and adolescents is a dramatically increasing problem throughout the world. In accordance with this data, the ratio of overweight renal recipient candidates and patients becoming obese after transplantation is rising.1 In a single-center study the obesity reported as a morbidity factor after transplantation in children has been assessed as 58.9%.6 Besides, there are relatively limited data in the literature about obesity and renal transplantation in this age

References (16)

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