Impact of kidney transplantation in obese candidates: a time-dependent propensity score matching study. - Université de Lille Accéder directement au contenu
Article Dans Une Revue Nephrol Dial Transplant Année : 2022

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

Résumé

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.
Fichier non déposé

Dates et versions

hal-04481444 , version 1 (28-02-2024)

Identifiants

Citer

Christel Castelli, Yohann Foucher, Julie Boucquemont, Mathilde Prezelin-Reydit, Magali Giral, et al.. Impact of kidney transplantation in obese candidates: a time-dependent propensity score matching study.. Nephrol Dial Transplant, 2022, Nephrol Dial Transplant, 37 (9), pp.1768-1776. ⟨10.1093/ndt/gfac152⟩. ⟨hal-04481444⟩
20 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More