Renal transplantationImmunosuppressionEffect of Obesity and Overweight on Cyclosporine Blood Levels and Renal Functions in Renal Adolescent 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
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Cited by (21)
Obesity-associated mesenteric lymph leakage impairs the trafficking of lipids, lipophilic drugs and antigens from the intestine to mesenteric lymph nodes
2022, European Journal of Pharmaceutics and BiopharmaceuticsCitation Excerpt :Several studies have previously reported that obesity is associated with reduced efficacy and increased risk of complications with cyclosporin treatment. For example, Kasap et al. reported poor renal function, including significantly increased serum creatinine levels and reduced glomerular filtration rate (GFR), in obese and/or overweight compared to lean renal transplant patients being treated with cyclosporin [52]. Bumgardner et al. reported a significant decrease in graft survival in both renal and pancreas transplant patients in obese compared to lean subjects receiving oral cyclosporin [53].
Pharmacokinetics of tacrolimus according to body composition in recipients of kidney transplants
2012, Kidney Research and Clinical PracticeCitation Excerpt :The current study is the first to demonstrate that body composition is one of several factors that should be considered in determining the tacrolimus level. Previously, some studies have shown that being overweight is a risk factor for high blood concentrations of calcineurin inhibitors [18–21]. Although their study was not designed to measure pharmacokinetics, Rodrigo and colleagues [18] showed that a transplant recipient group with a high BMI was associated with tacrolimus levels higher than 15 ng/mL.
Muscle and Fat Metabolism in Obesity After Kidney Transplantation: No Effect of Peritoneal Dialysis or Hemodialysis
2012, Journal of Renal NutritionFactors that affect concentrations of cyclosporine during the induction period of kidney transplantation: Multivariate analysis
2011, Transplantation ProceedingsCitation Excerpt :However, we found that indeed the standardized CsA concentrations increased as the BMI increased. Although the cause for this PK behavior has not yet been clarified, it has been suggested that as the BMI increases, CsA is distributed more extensively into blood cells and plasma lipids than into adipose tissue.18 The impact of concurrent immunosuppressive drugs in this series was limited because of the low number of patients on a triple or quadruple induction schedule (Table 1).
Obesity in Kidney Transplant Recipients and Candidates
2010, American Journal of Kidney DiseasesCitation Excerpt :Higher cyclosporine concentrations in obese patients were reported when it was dosed per kilogram of body weight; therefore, dosing based on ideal body weight has been suggested.51 Another study52 reported achieving similar cyclosporine levels at 0 and 2 hours in obese patients with lower cyclosporine doses than used in normal-weight adults. Older and obese transplant patients also were prone to higher tacrolimus trough levels when the drug was dosed by body weight.53
Asymmetric Dimethylarginine in Obesity After Renal Transplantation
2008, Journal of Renal Nutrition