Weight Gain Post–Renal Transplantation and Its Association With Glomerular Filtration Rate

OBJECTIVE

Obesity may be a risk factor for renal graft loss. The purpose of this study was to assess weight gain and its association with glomerular filtration rate after kidney transplant.

METHODS

This retrospective analysis of 152 adult renal transplant outpatients (77 males, 75 females; mean age, 45.6 +/- 10.1 years) with at least 6 months posttransplantation (post-tx) included body weight and creatinine clearance (CrCl) measured pretransplantation (pre-tx) as well as at 6 months (post-tx1), 1 year (post-tx2), 5 years (post-tx3), 10 years (post-tx4), 15 years (post-tx5), and 20 years (post-tx6) post-tx. Weight gain was determined by subtracting patient preoperative weight from the post-tx weights.

RESULTS

The weight gain post-tx versus pre-tx was progressive and significant (P < .001) post-tx1, 8.7 +/- 10.9% (n = 152); post-tx2, 12.4 +/- 11.5% (n = 150); post-tx3, 16.6 +/- 14.8% (n = 102); post-tx4, 20.1 +/- 18.1% (n = 47); post-tx5, 20.8 +/- 19.8% (n = 17); and post-tx6, 21.0 +/- 32.5% (n = 11). There was a positive and significant correlation between weight gain and CrCl during most times post-tx: post-tx2 (r = 0.32; P < .000); post-tx3 (r = 0.54; P < .0001); post-tx4 (r = 0.47; P = .01); and post-tx6 (r = 0.92; P < .001).

CONCLUSIONS

There was a great increase in body weight after kidney transplantation. The excessive body weight gain was associated with a better glomerular filtration rate.

Prevalence of Risk Factors for Cardiovascular Disease in Brazilian Renal Transplant Recipients

OBJECTIVE

Cardiovascular disease (CVD) is the major cause of death in renal transplant recipients. The aim of this study was to assess the prevalence of CVD risk factors among Brazilian adult renal transplant recipients.

METHODS

This cross-sectional study included 192 cases in which the evaluated CVD risk factors were hypertension, diabetes mellitus, impaired fasting glucose, obesity, overweight, abdominal obesity, metabolic syndrome, and dyslipidemia.

RESULTS

Hypertension, abdominal obesity, and hypercholesterolemia were the highest prevalent risk factors among the total population with prevalences of approximately 60%. The prevalence of obesity was significantly higher (P < .001) in recipients with normal graft function (28%) than in those with impaired graft function (7%). Abdominal obesity was also higher (P = .02) in the normal graft function group (77%) than in recipients with creatinine clearance (CrCl) values <60 mL/min (61%). There were positive, significant correlations between CrCl and body mass index (BMI) (r = 0.47; P < .001) and between CrCl and waist circumference (WC) (r = 0.44; P < .001). BMI (r = 0.31; P < .001) and WC (r = 0.27; P < .001) were also positively associated with triglyceride levels. There were negative associations of high-density lipoprotein (HDL)-cholesterol (HDL-c) with BMI (r = -0.28; P < .01) and WC (r = -0.32; P < .01).

CONCLUSIONS

The high prevalence of CVD risk factors among renal transplant recipients emphasizes the importance of taking appropriate therapeutic measures to reduce modifiable risk factors, reducing CVD and its consequences.

Iron, zinc, folate and vitamin B12 nutritional status and milk composition of low-income Brazilian mothers

The purpose of this study was to assess the nutritional status of low-income Brazilian mothers, who were supplemented with iron and vitamin B12 during pregnancy, in terms of iron, zinc, folate and vitamin B12, in different stages of lactation and to determine the influence of the maternal nutritional status on milk composition. The effect of folate supplementation during pregnancy on folate status of the nursing mothers and milk composition was investigated. The effect of partial weaning on maternal status and milk composition was also studied. In general, the nutritional status of iron, zinc, folate and vitamin B12 of the mothers appears adequate. However, some of the mothers had indices of status lower than normal limits for non-pregnant women. These values, particularly after 30 d post-partum, indicate that these mothers might be at nutritional risk and that the nutrient supplementation received during pregnancy was insufficient to meet demands. There was an increase with the stage of lactation for haematocrit, serum vitamin B12, serum zinc, serum albumin, milk folate and saturation of its binding protein, but there was a decrease for milk protein, total and whey-bound iron and zinc, and lactoferrin. Mothers who took folate supplements during pregnancy had higher serum folate levels immediately after birth than those not taking the supplements but no differences were found at later stages of lactation. Milk composition was not affected. Partial weaning did not affect the maternal nutritional status or the milk composition except for iron which was higher in milk from mothers who were partially breastfeeding.(ABSTRACT TRUNCATED AT 250 WORDS)