Variable Selection for Assessing Risk Factors for Weight and Body fat Gain During the First Year After Kidney Transplantation.
Gabriela Schmid-Mohler, Laura Huber, Thomas F Mueller
PMID 36136080WHAT IT FOUND
Weight and body fat gain after kidney transplant may be linked to baseline BMI, genes and lower physical activity.
Many other factors were controversial or weakly supported. Monitor weight and body fat, but this is not a validated risk score.
Key findings
01Of 538 articles searched, 16 longitudinal cohort studies met criteria for the narrative review of risk factors for weight or body fat gain in the first year after kidney transplantation.
02The literature review identified genes, lower physical activity, living donation and baseline BMI as risk factors, but expert opinion recommended not treating living donation as a risk factor.
03Several variables were not identified as risk factors, including creatinine clearance, pretransplant diabetes, dialysis modality, calcineurin inhibitors and haemoglobin, while age, ethnicity, income, gender, eating habits, rejection episodes, prednisone dose, immunosuppressive regimen, dyslipidemia, hypertension, food availability and depression had controversial results.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The paper is a narrative review and expert opinion, not a new study of patients, so it cannot show that acting on any factor prevents weight gain. Only 16 studies were included, and 7 had fewer than 100 kidney transplant recipients. Only 1 included study focused on body fat gain; the other 15 examined weight gain. Many factors had controversial, weak or no kidney transplant evidence, and some expert-counted risks were based on the general population rather than transplant recipients. The review did not test a risk-prediction model, sensitivity, specificity or clinical usefulness of the selected variables.
Declared interests
The authors declared no potential conflicts of interest and received no financial support.
The easy way to misread this
Do not read the list as a validated risk prediction tool. The review only identified potential factors, many had controversial or weak evidence, and no factor was tested for predicting or preventing weight gain.