First Testing of Literature-Based Models for Predicting Increase in Body Weight and Adipose Tissue Mass After Kidney Transplantation.
Gabriela Schmid-Mohler, Sonja Beckmann, Patrizia Zala and 6 others
PMID 36053125WHAT IT FOUND
Kidney transplant patients who quit smoking at transplant and reported better health had higher predicted risk of gaining at least 5% weight in year one.
Overweight patients had higher predicted fat mass gain, not total weight. These models were not tested in another group.
Key findings
01The weight-gain model had an area under the ROC curve of 0.797 and a significant overall model test (P = 0.023).
02In the multivariable weight model, smoking cessation at transplantation had an odds ratio of 16.425, each 1-point higher EQ-5D health rating had an odds ratio of 1.068, and BMI of 25 or higher had an odds ratio of 0.164.
03Baseline BMI of 25 or higher raised predicted odds of fat-mass gain (odds ratio 7.659) but lowered predicted odds of overall weight gain (odds ratio 0.164).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The prediction models were derived and tested in only one Swiss transplant cohort and were not validated in an external cohort. Many patients were excluded because of missing data: from 123 original participants, 88 were analyzed for weight gain and 79 for adipose tissue mass gain. Some predictor categories had few events, which may make the models unstable. Physical activity was self-reported and was measured 2-6 weeks after transplant, when patients may still be recovering from surgery, so it may not reflect usual behavior. The overall model test for adipose tissue mass gain was not significant, so the fat-mass findings are less secure than the weight-gain findings. The original intervention was usual care plus 7-8 counseling sessions focusing on weight management and physical activity, and this analysis cannot separate the contribution of any component. Prednisone dosage was not included in the model.
Declared interests
The authors reported no specific grant and no financial support for the research, authorship, or publication.
The easy way to misread this
Do not use these models to make clinical decisions yet. They were tested only in one Swiss kidney transplant cohort, had no external validation, and the overall test for the adipose tissue mass model was not significant (P = .052).