TY - JOUR
T1 - Association of obesity and muscle mass with risk of albuminuria in renal transplant recipients
AU - Zingerman, Boris
AU - Erman, Arie
AU - Mashraki, Tiki
AU - Chagnac, Avry
AU - Rozen-Zvi, Benaya
AU - Rahamimov, Ruth
N1 - Publisher Copyright:
© 2020, Italian Society of Nephrology.
PY - 2021/8
Y1 - 2021/8
N2 - Background: Increased albuminuria is a predictor of graft loss in kidney graft recipients. It is unknown whether obesity is an independent risk factor for the development of increased albuminuria in this population. The aim of this study was to elucidate the association between obesity and albuminuria in renal transplant recipients. Methods: We enrolled 330 renal transplant recipients and prospectively collected demographic, anthropomorphic, clinical and laboratory variables susceptible to influence albumin excretion. The outcome was albuminuria, measured using accurately timed urine collections. Data from 201 patients were analyzed after exclusion of participants with missing data and patients enrolled less than 6 months since renal transplantation. Analysis was carried out for an early and a late period, defined according to the 2.4-year median follow-up time. Results: Body mass index (BMI), waist circumference and urinary creatinine excretion rate were independent predictors of albuminuria in the late post-transplant period, indicating that the predictive value of body mass index for albuminuria is related to both increased abdominal fat mass and increased muscle mass. BMI was an independent predictor of microalbuminuria. Waist circumference and urinary creatinine were independent predictors of microalbuminuria for values above certain cutoffs: 110% of the accepted thresholds defining abdominal obesity and 1500 mg/day, respectively. Conclusions: These associations, which have not previously been reported, suggest, but do not prove, that an imbalance between metabolic demand and nephron mass may be responsible for increased albuminuria in the renal transplant population.
AB - Background: Increased albuminuria is a predictor of graft loss in kidney graft recipients. It is unknown whether obesity is an independent risk factor for the development of increased albuminuria in this population. The aim of this study was to elucidate the association between obesity and albuminuria in renal transplant recipients. Methods: We enrolled 330 renal transplant recipients and prospectively collected demographic, anthropomorphic, clinical and laboratory variables susceptible to influence albumin excretion. The outcome was albuminuria, measured using accurately timed urine collections. Data from 201 patients were analyzed after exclusion of participants with missing data and patients enrolled less than 6 months since renal transplantation. Analysis was carried out for an early and a late period, defined according to the 2.4-year median follow-up time. Results: Body mass index (BMI), waist circumference and urinary creatinine excretion rate were independent predictors of albuminuria in the late post-transplant period, indicating that the predictive value of body mass index for albuminuria is related to both increased abdominal fat mass and increased muscle mass. BMI was an independent predictor of microalbuminuria. Waist circumference and urinary creatinine were independent predictors of microalbuminuria for values above certain cutoffs: 110% of the accepted thresholds defining abdominal obesity and 1500 mg/day, respectively. Conclusions: These associations, which have not previously been reported, suggest, but do not prove, that an imbalance between metabolic demand and nephron mass may be responsible for increased albuminuria in the renal transplant population.
KW - Abdominal obesity
KW - Glomerular hyperfiltration
KW - Kidney transplant
KW - Microalbuminuria
KW - Muscle mass
UR - http://www.scopus.com/inward/record.url?scp=85093975028&partnerID=8YFLogxK
U2 - 10.1007/s40620-020-00883-1
DO - 10.1007/s40620-020-00883-1
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C2 - 33098523
AN - SCOPUS:85093975028
SN - 1121-8428
VL - 34
SP - 1315
EP - 1325
JO - Journal of Nephrology
JF - Journal of Nephrology
IS - 4
ER -