The views expressed in this article are those of the authors and do not reflect the official policy of the Department of the Navy, the Department of Defense or the US Government.
Obesity following kidney transplantation and steroid avoidance immunosuppression
Version of Record online: 13 FEB 2008
No claim to original US government works
Volume 22, Issue 3, pages 354–359, May/June 2008
How to Cite
Elster, E. A., Leeser, D. B., Morrissette, C., Pepek, J. M., Quiko, A., Hale, D. A., Chamberlain, C., Salaita, C., Kirk, A. D. and Mannon, R. B. (2008), Obesity following kidney transplantation and steroid avoidance immunosuppression. Clinical Transplantation, 22: 354–359. doi: 10.1111/j.1399-0012.2008.00792.x
- Issue online: 13 FEB 2008
- Version of Record online: 13 FEB 2008
- Accepted for publication 20 December 2007
- end-stage renal disease;
- kidney transplantation;
- steroid avoidance
Abstract: Obesity is an important co-morbidity within end-stage renal disease (ESRD) and renal transplant populations. Previous studies have suggested that chronic corticosteroids result in increased body weight post-transplant. With the recent adoption of steroid-sparing immunosuppressive strategies, we evaluated the effect of these strategies on body mass index (BMI) after renal transplantation. We examined 95 renal transplant recipients enrolled in National Institutes of Health clinical transplant trials over the past three yr who received either lymphocyte depletion-based steroid sparing or traditional immunosuppressive therapy that included steroids for maintenance immunosuppression. Recipients were overweight prior to transplant and no significant differences existed in pre-transplant BMI among treatment groups. Regardless of therapy, BMI increased post-transplant in all recipients. The BMI increase consisted of an average weight gain of 5.01 ± 7.12 kg (mean, SD) post-transplant. Additionally, in a number of recipients placed on maintenance steroids, subsequent withdrawal at a mean of 100 d post-transplant had no impact on weight gain. Thus, body weight and BMI increase following kidney transplantation, even in the absence of steroids. Thus, patients gain weight after renal transplantation regardless of the treatment strategy. Steroid avoidance alone does not reduce risk factors associated with obesity in our patient population.