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Pre-transplant morphometry by computed tomography scan and post-transplant dialysis risk in overweight or obese kidney transplant recipients

  • Urology - Original Paper
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Abstract

Purpose

Adipose distribution and sarcopenia could better assess kidney transplantation outcomes than body mass index (BMI) and have been poorly evaluated among obese and overweight recipients. We aimed to evaluate morphometric radiologic markers to predict post-operative dialysis within this population.

Methods

We conducted a retrospective study including patients with a BMI > 25 kg/m2 undergoing kidney transplantation during 5 years. Subcutaneous adipose tissue surface (SAT), visceral adipose tissue surface (VAT), and psoas surface were measured on CT scans sections. A model predictive of post-transplantation dialysis was elaborated through a multivariable logistic regression and was compared to a model including only BMI.

Results

Overall, 248 patients were included whom mean (SD) BMI and age were, respectively, 29.7 kg/m2 (3.6) and 56 years (12.7). Of them, 83 (33.5%) needed dialysis: 14 (5.7%) for primary kidney failure and 69 (27.8%) for delayed kidney function. On multivariable analysis, SAT, VAT and deceased donor were significantly associated with post-operative dialysis (respectively, OR [95%CI]:1.6 [1.1–2.6], 1.6[1.1–2.6], and 7.5 [1.6–56]). The area under the curve of this predictive model was 0.70 versus 0.64 for a BMI-based model.

Conclusion

High VAT and SAT were associated with post-transplantation dialysis. A predictive model based on these morphometrics could provide a better appreciation of graft recovery after transplantation among obese and overweight recipients. External validation is needed.

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Data availability

Data are available.

Code availability

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Funding

No funding was obtained for this study.

Author information

Authors and Affiliations

  1. Department of Urology and Transplantation Surgery, Hôpital de Bicêtre, AP-HP. Université Paris Saclay, 78 rue du général Leclerc, Le Kremlin-Bicêtre, 94270, Paris, France

    Ugo Pinar, Cédric Lebacle, Jacques Irani & Thomas Bessede

  2. Department of Internal Medicine, Hôpital Henri Mondor, AP-HP, Université Paris Saclay, Créteil, 94010, Paris, France

    Arthur Mageau

  3. Department of Visceral Surgery, Reims, Champagne-Ardenne University, Robert Debré University Hospital, Reims, France

    Yohann Renard

  4. Department of Urology and Kidney Transplantation, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, AP-HP. Sorbonne Université, 75013, Paris, France

    Xavier Rod & Benoit Barrou

  5. Department of Nephrology, Hôpital de Bicêtre, AP-HP. Université Paris Saclay, Le Kremlin-Bicêtre, 94270, Paris, France

    Mohamad Zaidan

  6. U1195, Université Paris-Saclay, Inserm, Le Kremlin-Bicêtre, 94276, Paris, France

    Thomas Bessede

Authors
  1. Ugo Pinar
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  2. Arthur Mageau
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  3. Yohann Renard
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  4. Xavier Rod
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  5. Cédric Lebacle
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  7. Mohamad Zaidan
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  8. Jacques Irani
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  9. Thomas Bessede
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Contributions

UP: participated in research design, data collection, writing of the paper, performance of the research, data analysis. AM: participated in research design, writing of the paper, performance of the research, data analysis. YR: participated in research design and data analysis. XR: participated in research design and data analysis. CL: participated in research design, writing of the paper and data collection. BB: participated in writing of the paper and data collection. MZ: participated in writing of the paper and data collection. JI: participated in research design, writing of the paper and data collection. TB: participated in research design, writing of the paper, performance of the research, data analysis.

Corresponding author

Correspondence to Ugo Pinar.

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For this study, oral and written consent was obtained for every patient.

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Pinar, U., Mageau, A., Renard, Y. et al. Pre-transplant morphometry by computed tomography scan and post-transplant dialysis risk in overweight or obese kidney transplant recipients. Int Urol Nephrol 53, 2469–2475 (2021). https://doi.org/10.1007/s11255-021-02995-4

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  • DOI: https://doi.org/10.1007/s11255-021-02995-4

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