Coronary events in obese hemodialysis patients before and after renal transplantation

• Published in: Clinical transplantation Vol. 29; no. 11; pp. 971 - 977
• Main Authors: De Lima, Jose Jayme G., Gowdak, Luis Henrique W., de Paula, Flavio J., Muela, Henrique Cotchi S., David-Neto, Elias, Bortolotto, Luiz A.
• Format: Journal Article
• Language: English
• Published: Denmark Blackwell Publishing Ltd 01.11.2015
• Subjects: chronic kidney disease; Coronary Artery Disease - etiology; Female; Follow-Up Studies; Glomerular Filtration Rate; hemodialysis; Humans; ischemic heart disease; Kidney Failure, Chronic - surgery; Kidney Function Tests; Kidney Transplantation - adverse effects; Male; Middle Aged; obesity; Obesity - complications; Postoperative Complications; Prognosis; Renal Dialysis - adverse effects; renal transplantation; Risk Factors; hemodialysis; ischemic heart disease; chronic kidney disease; renal transplantation; obesity
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.12616

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 cardiovascular (CV) events, and death. Obese HD patients were older (55.9 ± 9.2 vs. 54.2 ± 11), had more diabetes (54% vs. 40%), dyslipidemia (49% vs. 30%), altered myocardial scan (38% vs. 31%), myocardial infarction (MI) (16% vs. 10%), coronary intervention (11% vs. 7%), higher total cholesterol (186 ± 52 vs. 169 ± 47), and triglycerides (219 ± 167 vs. 144 ± 91). Obese undergoing TX had more dyslipidemia (46% vs. 31%), angina (23% vs. 14%), MI (18% vs. 5%), increased total cholesterol (185 ± 56 vs. 172 ± 48), and triglycerides (237 ± 190 vs. 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 predicts coronary events and death.