Evidence mapPaperPMID 28493926Full record

ArticlePloS one2017

Obesity and access to kidney transplantation in patients starting dialysis: A prospective cohort study.

Mathilde Lassalle, Léopold K Fezeu, Cécile Couchoud, Thierry Hannedouche, Ziad A Massy, Sébastien Czernichow

Registry-linked trialAbstract read
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04529278 (Efficacy and Tolerance of Liraglutide for Weight Loss in Obese Type 2 Diabetic Hemodialysis Patients), which is not on this map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04529278 phase2unknown statusstarted 2021, after this paper: background citation

Efficacy and Tolerance of Liraglutide for Weight Loss in Obese Type 2 Diabetic Hemodialysis Patients

Ran2021Enrolled18Registered outcomes8Posted comparisons0ConditionsDiabetes Mellitus, Type 2, Hemodialysis, ObeseArmsliraglutide
Open the trial in the graph
3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  12. The role of bariatric surgery on kidney transplantation: A systematic review and meta-analysis.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2021
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  20. Bariatric surgery before and after kidney transplantation: long-term weight loss and allograft outcomes.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mathilde LassalleREIN registry, Agence de la Biomédecine, F-93212 Saint-Denis-la-Plaine cedex, France.
Léopold K FezeuUniversité Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, INSERM (U1153), INRA (U1125), CNAM, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
Cécile CouchoudREIN registry, Agence de la Biomédecine, F-93212 Saint-Denis-la-Plaine cedex, France.
Thierry HannedoucheDepartment of Nephrology, University of Strasbourg & Hôpitaux Universitaires de Strasbourg, F-67000, Strasbourg, France.
Ziad A MassyDivision of Nephrology, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, F-92100, Boulogne-Billancourt, France.
Sébastien CzernichowINSERM UMS 011, F-94807, Villejuif, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity has been linked to poor access to medical care. Although scientific evidence suggest that kidney transplantation improves survival and quality of life in obese patients with end-stage renal disease (ESRD), few data exist on the impact of obesity on access to kidney transplantation in this population.

objectivesWe aimed to characterize the relationships between body mass index (BMI) at the start of dialysis, changes in BMI after the start of dialysis, and either access to kidney transplantation or overall mortality in dialysis or transplantation among ESRD patients.

methodsBetween 2002 and 2011, 19524 dialysis patients with ESRD were included in the study via the French nationwide Renal Epidemiology and Information Network. Data on sociodemographic factors, comorbidities and laboratory test results were recorded upon entry into the registry. BMI were obtained at the start of dialysis and then yearly. Cubic spline regression analyses provided a graphic evaluation of the relationships between BMI at the start of dialysis and outcomes. Joint models were used to evaluate the association between the change over time in BMI and outcomes.

resultsDuring a median follow-up of 20.3 months, 6634 patients underwent kidney transplantation. A BMI >31 kg/m2 at the start of the dialysis was associated with a lower likelihood of receiving a kidney transplant, and the likelihood decreased even further with higher BMI values. For patients with BMI ≥30kg/m2 at the start of the dialysis, a 1 kg/m2 decrease in BMI during follow-up was associated with a 9% to 11% increase in the likelihood of receiving a transplant. There was an L-shaped relationship between BMI at the start of dialysis and overall mortality. We showed that obese patients with ESRD face barriers to the receipt of a kidney transplant without valid reasons.

conclusionGreater attention to this issue would improve the fairness of the organ allocation process and might improve outcomes for obese patients with ESRD.

Indexed as

Health Services AccessibilityKidney TransplantationRenal DialysisAdolescentAdultAgedBody Mass IndexFemaleHumansKidney Failure, ChronicMaleMiddle AgedMultivariate AnalysisObesityProspective StudiesSensitivity and Specificity

Identifiers

PMID28493926
PMCPMC5426620

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.