Title :

Impact of kidney transplantation in obese candidates: a time-dependent propensity score matching study.

Author(s) :

Castelli, Christel [Auteur]
MethodS in Patients-centered outcomes and HEalth ResEarch [SPHERE]
Foucher, Yohann [Auteur]
MethodS in Patients-centered outcomes and HEalth ResEarch [SPHERE]
Boucquemont, Julie [Auteur]
Centre de recherche en épidémiologie et santé des populations [CESP]
Prezelin-Reydit, Mathilde [Auteur]
Université de Bordeaux [UB]
Giral, Magali [Auteur]
Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology [U1064 Inserm - CR2TI]
Savoye, Emilie [Auteur]
Agence de la biomédecine [Saint-Denis la Plaine]
Hazzan, Marc [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Lenain, Remi [Auteur]
MethodS in Patients-centered outcomes and HEalth ResEarch [SPHERE]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]

Journal title :

Nephrol Dial Transplant

Abbreviated title :

Nephrol Dial Transplant

Volume number :

37

Pages :

1768–1776

Publication date :

2022-04-26

ISSN :

1460-2385

English keyword(s) :

dialysis
kidney transplantation
obesity
propensity score
survival

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background Although kidney transplantation (KT) is considered the best treatment for end-stage renal disease (ESRD), there are concerns about its benefit in the obese population because of the increased incidence of ...
Show more >Background Although kidney transplantation (KT) is considered the best treatment for end-stage renal disease (ESRD), there are concerns about its benefit in the obese population because of the increased incidence of post-transplant adverse events. We compared patients who underwent KT versus patients awaiting KT on dialysis. Methods We estimated the life expectancy [restricted mean survival time (RMST)] for a 10-year follow-up by matching on time-dependent propensity scores. The primary outcome was time to death. Results In patients with a body mass index (BMI) ≥30 kg/m2 (n = 2155 patients per arm), the RMST was 8.23 years [95% confidence interval (CI) 8.05–8.40] in the KT group versus 8.00 years (95% CI 7.82–8.18) in the awaiting KT group, a difference of 2.71 months (95% CI −0.19–5.63). In patients with a BMI ≥35 kg/m2 (n = 212 patients per arm), we reported no significant difference [8.56 years (95% CI 7.96–9.08) versus 8.66 (95% CI 8.10–9.17)]. Hence we deduced that KT in patients with a BMI between 30 and 35 kg/m2 was beneficial in terms of life expectancy. Conclusion Regarding the organ shortage, KT may be questionable for those with a BMI ≥35 kg/m2. These results do not mean that a BMI ≥35 kg/m2 should be a barrier to KT, but it should be accounted for in allocation systems to better assign grafts and maximize the overall life expectancy of ESRD patients.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-12T01:43:07Z
2024-02-28T08:35:57Z