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Obesity Treatment Helps Reduce Atherosclerosis Risk After Renal Transplant: Presented at ERA-EDTA

By Lynda Jackson

COPENHAGEN, DENMARK -- July 18, 2002 -- A new post-transplant treatment regimen involving a hypoenergetic, hyperlipidaemic diet may be useful in lowering the risk for atherosclerosis and chronic rejection in obese renal transplant patients.

Dr. Vladimir Teplan, from the department of nephrology, Transplant Centre, Institute of Clinical Experimental Medicine, Prague, Czech Republic, presented the study results here July 17^th at the 39^th annual Congress of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA).

Obesity is especially associated with other risk factors such as hyperlipidaemia, hypertriglyceridaemia, cardiovascular complications, and in long-term follow-up, chronic allograph nephropathy. Previous research has demonstrated that obese patients do not differ genetically from the general Czech population, Dr. Teplan reported. There are issues not only associated with surgery but also with type of obesity, he said, and in this study it is abdominal in both men and women and is of high prevalence, ranging between 25 percent and 35 percent.

This was a prospective randomised study in 258 obese patients (body mass index [BMI] of at least 30 kg/m², age 22 to 78 years) following kidney transplantation.

Dr. Teplan explained that the investigators compared data from 128 patients on a new regimen (group A) with data obtained from 130 patients not treated systematically from year 1 post transplant (group B). All patients received cyclosporin, mycophenolate mofetil, and prednisone. Patients in Group A were started on an individualised hypoenergetic, hypolipidaemic diet and corticoid withdrawal. After three months, the diet was regularly supplemented with orlistat 120 mg three times per day and statin therapy.

During three-year follow-up there were significant changes in BMI in Group A:

· BMI 33.5±3.3 kg/m² pre-diet vs. 27.3±3.2 kg/m² during follow-up (p<0.01);

· Total cholesterol 6.9±2.4 mmol/L vs. 5.2±2.3 mmol/L (p<0.01);

· Triglycerides 3.8±1.6 mmol/L vs. 2.3±0.6 mmol/L (p<0.01);

· LDL cholesterol 4.1±1.2 mmol/L vs. 3.0±0.7 mmol/L (p<0.01);

· Fasting glycaemia 7.6±3.2 mmol/L vs. 5.2±2.0 mmol/L (p<0.01);

· HDL cholesterol/triglycerides 0.28±0.04 mmol/L vs. 0.38±0.06 mmol/L (p<0.025);

· Creatinine clearance 1.2±0.2 mL/s vs. 0.9±0.2 mL/s (p<0.025).


Significant differences were also found between groups in creatinine clearance and proteinuria (p<0.01).

These findings show that a new regimen for the treatment of obesity in transplant patients can be effective in reducing the risk of atherosclerosis and progression of chronic rejection.

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