Título:
Impacto del sobrepeso-obesidad en pacientes con trasplante renal: estudio retrospectivo en el Hospital de Clínicas durante el período 2000-2018
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Autor:
Añón, María Belén
Briosso, Facundo
Invernizzi, Mariana
Julián, Camila
Mendoza, Mateo
Villar, Sebastián
Briosso, Facundo
Invernizzi, Mariana
Julián, Camila
Mendoza, Mateo
Villar, Sebastián
Tutor:
Seija, Mariana
Noboa, Agustín
Nin, Marcelo
Noboa, Agustín
Nin, Marcelo
Tipo de documento:
Monografía
Editor:
Palabras clave:
Trasplante renal
Sobrepeso
Obesidad
Diabetes mellitus
Riesgo cardiovascular
Kidney transplant
Overweight
Obesity
Cardiovascular risk
Sobrepeso
Obesidad
Diabetes mellitus
Riesgo cardiovascular
Kidney transplant
Overweight
Obesity
Cardiovascular risk
Descriptores:
Año de publicación:
2019
Contenido:
Resumen:
El objetivo del estudio fue determinar los efectos del sobrepeso-obesidad en el desarrollo de comorbilidades en trasplante renal (TR).
Metodología: Estudio de cohorte retrospectivo, observacional, analítico. Incluyó 268 TR realizados en el Hospital de Clínicas (1/1/2000 - 30/4/2018). Se realizó revisión de historias clínicas. El proyecto fue aprobado por el comité de ética.
Resultados: Se categorizaron pacientes según IMC pre-trasplante: bajopeso (n=30), normopeso (n=127), sobrepeso (n=79), obesidad (n=32). La mayor variación de peso ocurre en los primeros 3 años post-trasplante en todas las categorías. El grupo bajopeso, presentó un aumento de peso de 4% en los primeros meses. El grupo normopeso, tuvo una ganancia sostenida de 1% anual. Luego del primer año, todos los grupos presentaron un aumento continuo, excepto el grupo obesidad. El único factor de riesgo para obesidad de-novo fue ser normopeso pre-trasplante (OR 20.519).
El porcentaje de eventos cardiovasculares fue mayor en el grupo obesidad pre-trasplante (14,3% versus normopeso 3,7%) (p=0,045). Luego del año 3, mayor proporción de pacientes cumplieron las metas terapéuticas para perfil lipídico y presión arterial (PA) (de 50 a 90%) independientemente del grupo. El control de Hemoglobina glicosilada en diabéticos fue menor al 10%. Los pacientes con sobrepeso-obesidad en el post-trasplante presentaron mayor proporción de diabetes post-trasplante, en comparación con los normopeso-bajopeso post (p=0,01). La sobrevida global de los pacientes con obesidad a los 5 años fue menor (85% versus sobrepeso 93%, normopeso 94%), no significativo.
Conclusiones: La frecuencia de eventos cardiovasculares post trasplante renal fue mayor en el grupo obesidad pre-TR. Las principales variaciones de peso corporal se produjeron en los primeros 3 años luego del trasplante. Los pacientes con mayor riesgo de desarrollar obesidad post trasplante, fueron los pacientes con normopeso previo al trasplante. De este estudio se desprende se requieren intervenciones multidisciplinarias precoces, para evitar el desarrollo de obesidad y comorbilidades.
The objective of this study was to determine the effects over weight-obesity have on the development of comorbidities in kidney transplantation (KT). Methodology: Retrospective cohort study, observational, analytic. Inclusion of 268 kidney transplantations that had taken place in the Hospital de Clínicas (1/1/2000 – 30/4/2018), clinical chart were reviewed. This project was approved by the ethical committee. Results: We categorized the patients based on their Body Mass Index (BMI) pre-transplant: underweight (n=30), normal weight (n=127), overweight (n=79), obese (n=32). The maximum variation of weight occurs in the first 3 years post-transplant in all of the categories. The underweight group, presented an increase of 4% in their weight the first months. The normal weight group had a yearly sustained increase of 1%. After the first year, all of the groups presented a continuous increase, except the obese group. The only risk factor for obesity de-novo was being normal weight pre-transplant (OR 20.519). The percentage of cardiovascular events were greater in the obese group pre-transplant (14,3% versus normal weight 3,7%) (p=0,045). After the third year, a greater proportion of patients fulfilled therapeutic goals for lipid profile and blood pressure (from 50 to 90%), independent of their group. The control of Glycosylated Hemoglobin in diabetics was less than 10%. The overweight-obese patients in the post-transplant phase presented a higher proportion of DM post-transplant, in comparison with the normal weight-underweight post KT (p=0,01). The overall survival of the patients with obesity 5 years later was less (85% versus overweight 93% , normal weight 94%), which was not significant. Conclusions: The frequency of cardiovascular events post kidney transplantation were larger in the obese group pre-KT. The principle variations of weight were produced in the first 3 years after the transplant. The patients with the highest risk of developing obesity post- transplant, were the patients with normal weight prior to the transplant. This study highlights the need for multidisciplinary approach to avoid the development of obesity and comorbidities.
The objective of this study was to determine the effects over weight-obesity have on the development of comorbidities in kidney transplantation (KT). Methodology: Retrospective cohort study, observational, analytic. Inclusion of 268 kidney transplantations that had taken place in the Hospital de Clínicas (1/1/2000 – 30/4/2018), clinical chart were reviewed. This project was approved by the ethical committee. Results: We categorized the patients based on their Body Mass Index (BMI) pre-transplant: underweight (n=30), normal weight (n=127), overweight (n=79), obese (n=32). The maximum variation of weight occurs in the first 3 years post-transplant in all of the categories. The underweight group, presented an increase of 4% in their weight the first months. The normal weight group had a yearly sustained increase of 1%. After the first year, all of the groups presented a continuous increase, except the obese group. The only risk factor for obesity de-novo was being normal weight pre-transplant (OR 20.519). The percentage of cardiovascular events were greater in the obese group pre-transplant (14,3% versus normal weight 3,7%) (p=0,045). After the third year, a greater proportion of patients fulfilled therapeutic goals for lipid profile and blood pressure (from 50 to 90%), independent of their group. The control of Glycosylated Hemoglobin in diabetics was less than 10%. The overweight-obese patients in the post-transplant phase presented a higher proportion of DM post-transplant, in comparison with the normal weight-underweight post KT (p=0,01). The overall survival of the patients with obesity 5 years later was less (85% versus overweight 93% , normal weight 94%), which was not significant. Conclusions: The frequency of cardiovascular events post kidney transplantation were larger in the obese group pre-KT. The principle variations of weight were produced in the first 3 years after the transplant. The patients with the highest risk of developing obesity post- transplant, were the patients with normal weight prior to the transplant. This study highlights the need for multidisciplinary approach to avoid the development of obesity and comorbidities.
Descripción:
Editorial:
Udelar. FM
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Citación:
Añón M, Briosso F, Invernizzi M y otros. Impacto del sobrepeso-obesidad en pacientes con trasplante renal: estudio retrospectivo en el Hospital de Clínicas durante el período 2000-2018 [en línea]. Monografía de Pre Grado. Montevideo: Udelar. FM, 2019. 35 p.
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https://hdl.handle.net/20.500.12008/33776
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Licencia Creative Commons Atribución - No Comercial - Sin Derivadas (CC - By-NC-ND 4.0)
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URUGUAY
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| Ficheros | Descripción | Tamaño | Formato | ||
|---|---|---|---|---|---|
| MCII_2019_G52.pdf | Impacto del sobrepeso-obesidad en pacientes con trasplante renal: estudio retrospectivo en el Hospital de Clínicas durante el período 2000-2018 | 2.09 MB | Adobe PDF |