ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2019
Association Between Weight Loss Before Deceased Donor Kidney Transplantation and Posttransplantation Outcomes.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Management of obesity in kidney transplant candidates and recipients: A clinical practice guideline by the DESCARTES Working Group of ERA.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Guideline
- Trajectory-based weight modeling distinguishes pathologic weight loss and predicts adverse events in nonhuman primate allogeneic kidney transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- Impact of waitlist weight change on outcomes in heart transplant recipients: a UNOS database analysis.General thoracic and cardiovascular surgery · 2025Article
- Obesity Weight Loss Phenotypes in CKD: Findings From the Chronic Renal Insufficiency Cohort Study.Kidney international reports · 2023Article
- Post-kidney transplant body mass index trajectories are associated with graft loss and mortality.Clinical transplantation · 2023Article
- Obesity and chronic kidney disease: A current review.Obesity science & practice · 2023Review
- When There is No Guidance From the Guidelines: Renal Transplantation in Recipients With Class III Obesity.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- Body mass index affects kidney transplant outcomes: A cohort study over 5 years using a steroid sparing protocol.Frontiers in endocrinology · 2023Observational
- Allograft function and muscle mass evolution after kidney transplantation.Journal of cachexia, sarcopenia and muscle · 2022Article
- Obesity Management in Kidney Transplant Candidates: Current Paradigms and Gaps in Knowledge.Advances in chronic kidney disease · 2021Review
- Pre-kidney transplant unintentional weight loss leads to worse post-kidney transplant outcomes.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Article
- Obesity and bariatric surgery in kidney transplantation: A clinical review.World journal of diabetes · 2021Review
- Effects of body mass index on kidney transplant outcomes are significantly modified by patient characteristics.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Approaches to Obesity Management in Dialysis Settings: Renal Dietitian Perspectives.Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2020Article
- Tackling the weight list problem.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020Article
- Weighing the waitlist: Weight changes and access to kidney transplantation among obese candidates.PloS one · 2020Article
- Obesity affects graft function but not graft loss in kidney transplant recipients.The Journal of international medical research · 2020Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
RATIONALE &
objectiveThere is debate on whether weight loss, a hallmark of frailty, signals higher risk for adverse outcomes among recipients of deceased donor kidney transplantation (DDKT). STUDY
designRetrospective cohort study. SETTING &
participantsUsing national Organ Procurement and Transplantation Network data, we included all DDKT recipients in the United States between December 4, 2004, and December 3, 2014, who were adults (aged ≥ 18 years) when listed for DDKT. EXPOSURES: Relative pre-DDKT weight change as a continuous predictor and categorized as <5% weight change from listing to DDKT, ≥5% to <10% weight loss, ≥10% weight loss, ≥5% to <10% weight gain, and ≥10% weight gain. OUTCOMES: We examined 3 post-DDKT outcomes: (1) transplant hospitalization length of stay (LOS) in days, (2) all-cause graft failure, and (3) mortality. ANALYTIC APPROACH: Unadjusted fractional polynomial methods, multivariable log-gamma models, and multivariable Cox proportional hazards models.
resultsAmong 94,465 recipients of DDKT, median pre-DDKT weight change was 0 (interquartile range, -3.5 to +3.9) kg. There were nonlinear unadjusted associations between relative pre-DDKT weight loss and longer transplant hospitalization LOS, higher all-cause graft loss, and higher mortality. Compared with recipients with <5% pre-DDKT weight change (n = 49,366; 52%), recipients who lost ≥10% of their listing weight (n = 10,614; 11%) had 0.66 (95% CI, 0.23-1.09) days longer average transplant hospitalization LOS (P = 0.003), 1.11-fold higher graft loss (adjusted HR [aHR], 1.11; 95% CI, 1.06-1.17; P < 0.001), and 1.18-fold higher mortality (aHR, 1.18; 95% CI, 1.11-1.25; P < 0.001) independent of recipient, donor, and transplant factors. Pre-DDKT dialysis exposure, listing body mass index category, and waiting time modified the association of pre-DDKT weight change with hospital LOS (interaction P < 0.10), but not with all-cause graft loss and mortality. LIMITATIONS: Unmeasured confounders and inability to identify volitional weight change. Also, the higher significance level set to increase the power of detecting interactions with the fixed sample size may have resulted in increased risk for type 1 error.
conclusionsDDKT recipients with ≥10% pre-DDKT weight loss are at increased risk for adverse outcomes and may benefit from augmented support post-DDKT.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.