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ERA-EDTA: Aggressive Obesity Treatment Improves Outcomes in Renal Transplant Recipients
By Alison Palkhivala
COPENHAGEN, DENMARK -- July 17, 2002 -- Treating obesity aggressively after patients undergo renal transplantation may improve their long-term outcome, according to a prospective, randomised study.
Researchers presented the results achieved with their new regimen here July 17 at the 39th annual Congress of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA).
Obesity is a known risk factor for atherosclerosis and chronic allograft nephropathy in patients who undergo renal transplantation. Dr. Vladimir Teplan and colleagues from the department of nephrology transplant center at the Clinical Institute of Experimental Medicine in Prague, Czech Republic developed a regiment to help improve outcomes in these patients.
To determine whether the regimen had an impact on transplant outcomes, Dr. Teplan's team recruited 258 renal transplant recipients who had a body mass index (BMI) of 30 kg/mē or greater. They monitored these patients for a period of 36 months after surgery.
All patients received cyclosporin A, mycophenolate mofetil, and prednisone postoperatively. A group of 128 patients were randomised to follow the obesity treatment regimen consisting of an individualised hypoenergetic and hypolipidaemic diet and corticoid withdrawal followed three months later by orlistat and statin therapy. The researchers compared their outcome with those of the 130 patients not given special obesity treatment.
After a follow-up of up to three years, patients who underwent the obesity treatment regimen had significantly lower BMIs, total cholesterol levels, triglyceride levels, and fasting glycaemic levels than did the control patients who did not receive the obesity treatment regimen. The obesity treatment group also had superior levels of high-density lipoprotein, creatinine clearance, and proteinuria. The two groups were similar with respect to cyclosporin levels and genetic analysis of apo E and ACE polymorphisms.
The researchers concluded that their new regimen could help reduce the risk of atherosclerosis and progression of chronic rejection in patients renal transplant recipients.
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