ABSTRACT
INTRODUCTION: The relationship between BMI and early renal function recovery after kidney transplantation is important due to the rising global obesity rates. METHODS: A retrospective study on 320 patients who received allograft kidney transplantation at Guangxi Medical University Hospital explored the BMI-kidney function relationship using various statistical methods. Mendelian randomization (MR) was also employed to investigate causality. RESULTS: Based on the univariate analysis, multivariate linear regression models, and trend analysis, it was found that there were significant positive correlations between BMI and creatinine, urea, and cystatin C on the 7th day after kidney transplantation (p < 0.05). The sensitivity analysis further confirmed these correlations in different gender stratification, adolescents, and adults. However, the positive correlation with cystatin C was only significant in males. Additionally, after conducting smooth curve fitting analysis and threshold saturation analysis, it was revealed that the negative correlation between early renal function recovery was most significant when BMI was between 22.0 and 25.5 kg/m2, and early postoperative renal function may be optimal when BMI was at 22.2 kg/m2. Finally, the MR analysis confirmed a causal relationship between BMI and renal failure, as indicated by the IVW method (p = 0.003), as well as the weighted median estimator (p = 0.004). CONCLUSION: This study on kidney transplant patients found that maintaining a BMI within the range of 22.0-25.5 kg/m2, with an optimal BMI of 22.2 kg/m2, improves early renal function recovery. This correlation holds true for different age-groups and genders. Monitoring and controlling BMI in high-risk patients can enhance post-transplantation renal function.
ABSTRACT
Objective:To analysis the clinical and histopathological features, and the effect of surgical treatment and adjuvant therapy for the survival in patients of head and neck mucosal melanomaï¼HNMMï¼. Method:A retrospective analysis was conducted on the clinical data of 46 patients with HNMM, and the factors related to survival were analyzed. Kaplan-Meier analysis was used for survival analysis. Log-rank test was used for univariate analysis, and COX proportional hazard model was used for multivariate analysis. Result:The 3 and 5 year cumulative survival rates of 46 patients with HNMM were 47.5% and 34.1%, respectively, and the median survival time was 36 months. Univariate analysis revealed that the factors affecting survival rates in patients with HNMM included tumor staging, surgical margins, postoperative targeted therapy, distant metastasis and local recurrenceï¼P<0.05ï¼. Multiple factor COX regression analysis showed that distant metastasis, tumor staging, surgical margins were independent risk factors for survival rates in patients with HNMM, and postoperative targeted therapy was the protective factor. Conclusion:HNMM is of high malignancy and low survival rate. Early diagnosis and complete surgical resection are the primary methods to improve the survival, and postoperative targeted therapy may be an intervention to improve the survival.