Impact of tobacco smoking on pulmonary and kidney function after successful kidney transplantation - A single-centre pilot study.

The all consequences of tobacco smoking on the lungs and kidney function in kidney transplant recipients are unknown. We investigate the impact of tobacco smoking on lung and kidney functions in kidney transplantation recipients. METHODS: Finally, 55 patients were evaluated after kidney transplantation (age 50.8±13.4). Pulmonary function was performed using spirometer Pneumo Screen; anthropometry with body composition using electronic scale, dynamometer, and multi-frequency bioimpedance analysis. Biochemical parameters were measured in serum, eGFR was calculated according to the CKD-EPI formula. RESULTS: Smoking history was reported by 23 kidney transplant recipients (42%); among them 12 (22%) were current smokers (mean pack-years=28.3±15.2). There were significant differences of spirometry parameters (FEV1, FEV1/FVC, MMEF% predictive value) between non-smokers vs active smokers (p<0.003; p<0.005; p<0.04; respectively). Current smokers presented significantly lower eGFR and higher IL-6 serum levels compare to both-past smokers and non-smokers (p<0.02; p<0.04 respectively), the other biochemical parameters did not differ between these groups. The pack-years positively correlated with MRC dyspnoe scale and triglycerides, and negatively with HDL cholesterol levels. CONCLUSIONS: Active tobacco smoking was relatively common in kidney transplant recipients and was associated with poorer pulmonary function, systemic inflammation, and its possible impact on kidney graft. Other parameters of inflammation associated with renal function should be studied in active smokers before and after kidney transplantation. Effective smoking cessation programs are required in patients before and after kidney transplantation.

Analysis of Serum Fatty Acids Profile in Kidney Transplant Recipients.

Patients with end-stage kidney disease, treated with renal transplantation, are at increased risk of cardio-vascular disease (CVD) and cardio-vascular mortality. They are also characterized by an atherogenic dyslipidemia. Alterations of the fatty acids (FA) profile contribute to increased cardio-vascular risk in the general population. In the current study, we test the hypothesis that kidney transplantation is associated with ab-normalities in FA profile. The FA profile was analyzed by gas chromatography-mass spectrometry in 198 renal transplant recipients, and 48 control subjects. The most profound differences between renal transplant patients and controls were related to the content of branched chain FA, monounsaturated FA, and n-6 polyunsaturated FA, respectively. The FA profile significantly separated the patients from the controls in the principal component analysis (PCA). The abnormalities of FA profile showed a tendency for normalization in long-term kidney recipients, as compared to patients with recent transplants. The n-3 PUFA content demonstrated a strong inverse association with the presence of inflammation. Most profound alterations of the FA profile were observed in patients with impaired graft function (glomerular filtration rate < 45 mL/min). The study demonstrated significant disorders of the FA profile in kidney transplant recipients, which might contribute to cardio-vascular risk in this vulnerable patient population.

Obesity After Successful Kidney Transplantation.

BACKGROUND: Kidney transplantation is the most effective method of renal replacement therapy, providing better quality of life and improving survival prognosis. However, immunosuppressive therapy may negatively affect balance in recipients' body mass components, such as fat mass and lean tissue mass and consequently may result in weight gain. The purpose of the study was to investigate body composition and prevalence of obesity in a group of kidney transplant recipients (KTRs) during 2 years of observation. METHODS: The study population consisted of 95 patients after kidney transplantation. Anthropometry were performed using an electronic scale, dynamometer, and multi-frequency bioimpedance analysis at baseline and over a 24-month observation period. Obesity diagnosis was based on body mass index (BMI). Sarcopenia was defined according to The European Working Group on Sarcopenia. RESULTS: At baseline, overweight and obesity were found in 42.1% and 10.5% of KTRs, respectively. BMI correlated positively with body fat, lean body mass, and waist circumference (P < .05). Of all KTRs, 31.6% at baseline and 33.6% after 2 years met criteria of sarcopenia. During 24 months' observation, the kidney graft function and mean BMI were stable, but significant increase of body fat content with decrease of lean body mass was observed. Multivariate regression analysis showed a relationship between the risk of sarcopenia and low BMI and high waist circumference. CONCLUSIONS: Successful transplantation was associated with weight gain with increase of body fat without increase in lean body mass (sarcopenic obesity). Results suggest the need for routine assessment of body composition and nutritional education that could prevent the consequences of adipose tissue accumulation in kidney transplant recipients.