ArticlePediatric nephrology (Berlin, Germany)2018
Outcomes of underweight, overweight, and obese pediatric kidney transplant recipients.
Article in Pediatric nephrology (Berlin, Germany), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Association of obesity with mortality and clinical outcomes in children and adolescents with transplantation: A systematic review and meta-analysis.Reviews in endocrine & metabolic disorders · 2021Pooled it
- Beyond biological risk: socioeconomic vulnerability and adverse pediatric kidney transplant outcomes.Pediatric nephrology (Berlin, Germany) · 2026Article
- Inverted kidney allograft technique in pediatric kidney transplantation Results from a single-center, comparative analysis.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026Article
- Multidimensional Assessment of Neurological Adverse Reactions Related to PD-1 Inhibitors: A Real-World Pharmacovigilance Study.CNS neuroscience & therapeutics · 2026Article
- Kidney transplant outcomes in obese pediatric patients.World journal of nephrology · 2025Article
- Obesity and pediatric renal transplant: An unholy alliance.World journal of nephrology · 2025Article
- Identifying Risk Factors for Graft Failure due to Chronic Rejection < 15 Years Post-Transplant in Pediatric Kidney Transplants Using Random Forest Machine-Learning Techniques.Pediatric transplantation · 2025Article
- Multidisciplinary approach to optimizing long-term outcomes in pediatric kidney transplant recipients: multifaceted needs, risk assessment strategies, and potential interventions.Pediatric nephrology (Berlin, Germany) · 2025Review
- Weight of evidence: reevaluating BMI criteria as a barrier for kidney transplantation in children.Pediatric nephrology (Berlin, Germany) · 2025Article
- Rapid Weight Gain After Pediatric Kidney Transplant and Development of Cardiometabolic Risk Factors Among Children Enrolled in the North American Pediatric Renal Trials and Collaborative Studies Cohort.Pediatric transplantation · 2025Article
- Body mass index in pediatric kidney transplant selection criteria.Pediatric nephrology (Berlin, Germany) · 2024Article
- Role of Nutrients in Pediatric Non-Dialysis Chronic Kidney Disease: From Pathogenesis to Correct Supplementation.Biomedicines · 2024Review
- A novel risk score for predicting prolonged length of stay following pediatric kidney transplant.Pediatric nephrology (Berlin, Germany) · 2023Article
- Anthropometric measures and patient outcome in pediatric chronic kidney disease.Pediatric nephrology (Berlin, Germany) · 2023Article
- Associations of longitudinal height and weight with clinical outcomes in pediatric kidney replacement therapy: results from the ESPN/ERA Registry.Pediatric nephrology (Berlin, Germany) · 2023Article
- Physical performance capacity after pediatric kidney transplant and clinical parameters associated with physical performance capacity.Pediatric nephrology (Berlin, Germany) · 2023Article
- Associations of body mass index (BMI) and BMI change with progression of chronic kidney disease in children.Pediatric nephrology (Berlin, Germany) · 2023Article
- Malnutrition Patterns in Children with Chronic Kidney Disease.Life (Basel, Switzerland) · 2023Review
- Malnutrition and immune cell subsets in children undergoing kidney transplantation.Pediatric transplantation · 2022Article
- Single kidney transplantation from pediatric deceased donors in China: the outcomes and risk factors of graft survival.Translational pediatrics · 2022Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObesity is a risk factor for poor transplant outcomes in the adult population. The effect of pre-transplant weight on pediatric kidney transplantation is conflicting in the existing literature.
methodsData was collected from the Organ Procurement and Transplantation Network (OPTN) database on recipients aged 2-21 years who received a kidney-only transplant from 1987 to 2017. Recipients were categorized into underweight, normal, overweight, and obese cohorts. Using adjusted regression models, the relationship between recipient weight and various graft outcomes (delayed graft function [DGF], acute rejection, prolonged hospitalization, graft failure, mortality) was examined.
results18,261 transplant recipients (mean age 14.1 ± 5.5 years) were included, of which 8.7% were underweight, 14.8% were overweight, and 15% were obese. Obesity was associated with greater odds of DGF (OR 1.3 95% CI 1.13-1.49, p < 0.001), acute rejection (OR 1.23 95% CI 1.06-1.43, p < 0.01), and prolonged hospitalization (OR 1.35 95% CI 1.17-1.54, p < 0.001) as well as greater hazard of graft failure (HR 1.13 95% CI 1.05-1.22, p = 0.001) and mortality (HR 1.19 95% CI 1.05-1.35, p < 0.01). The overweight cohort had an increased risk of graft failure (HR 1.08 95% CI 1.001-1.16, p = 0.048) and increased odds of DGF (OR 1.2 95% CI 1.04-1.38, p = 0.01) and acute rejection (OR 1.18 95% CI 1.01-1.38, p = 0.04). When stratified by age group, the increased risk was realized among younger and older age groups for obese and overweight. Underweight had lower risk of 1-year graft failure (HR 0.82 95% CI 0.71-0.94, p < 0.01), overall graft failure in the 13-17-yr. age group (HR 0.84 95% CI 0.72-0.99, p = 0.03) and acute rejection in the 2-5-yr. age group (OR 0.24 95% CI 0.09-0.66, p < 0.01).
conclusionPre-transplant weight status and age impact pediatric kidney transplant outcomes. Recipient underweight status seems to be protective against adverse outcomes while overweight and obesity may lead to poorer graft and patient outcomes.
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