Coronary Events in Obese Hemodialysis Patients Before and After Renal Transplantation [feedly]

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Coronary Events in Obese Hemodialysis Patients Before and After Renal Transplantation
// Clinical Transplantation

Abstract

We examined the impact of obesity (BMI ≥ 30 kg/m², n=357) on prognosis in 1696 hemodialysis (HD) patients before and after renal transplantation (TX). End-points were coronary events, composite CV events, and death.

Obese HD patients were older (55.9 ± 9.2 v 54.2 ± 11), had more diabetes (54% v 40%), dyslipidemia (49% v 30%), altered myocardial scan (38% v 31%), MI (16% v 10%), coronary intervention (11% v 7%), higher total-cholesterol (186 ± 52 v 169 ± 47), and triglycerides (219 ± 167 v 144 ± 91). Obese undergoing TX had more dyslipidemia (46% v 31%), angina (23% v 14%), MI (18% v 5%), increased total-cholesterol (185 ± 56 v 172 ± 48) and triglycerides (237 ± 190 v 149 ± 100). Obesity was independently associated with coronary events (Log-rank=0.008, HR 2.55 %CI 1.27-5.11) and death (Log-rank 0.046, HR 1.52, % CI 1.007 – 2.30) in TX but not in HD.

Obese HD patients had more risk factors and ischemic heart disease but these characteristics did not interfere with prognosis. In TX patients obesity predict coronary events and death.

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