Abstract: TH-PO814
BMI in Pediatric Kidney Transplant Candidates: Association with Neurodevelopmental Outcomes
Session Information
- Transplantation: Clinical - 2
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Gu, Lidan, University of Minnesota Medical School, Minneapolis, Minnesota, United States
- Glad, Danielle M., Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Anzalone, Christopher J., Boston Children's Hospital, Boston, Massachusetts, United States
- Kane-Grade, Finola E., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
- Evans, Michael David, University of Minnesota Medical School, Minneapolis, Minnesota, United States
- Kizilbash, Sarah J., University of Minnesota Medical School, Minneapolis, Minnesota, United States
Background
Recent studies indicated that both low and high body mass index (BMI) in pediatric kidney transplant patients is linked to higher graft failure and mortality risk (al Tamimi et al., 2023; Bonthuis et al., 2023; Winnicki et al., 2018). However, the interaction of BMI, neurocognitive outcomes, and transplant outcomes has not been explored. This study aimed to evaluate the association between BMI, neurocognitive outcomes, and transplant outcomes.
Methods
A retrospective study was completed for 75 patients aged 3 to 17 years who completed pre-transplant neuropsychological evaluations at University of Minnesota Medical Center between 2010 and 2022. Neurocognitive outcome variables include Full Scale IQ, Verbal Comprehension, Nonverbal Reasoning, Working Memory, and Processing Speed. Medical (i.e., pre-transplant BMI, eGFR 1 year and 5 years post-transplant) and demographic variables were retrieved from the electronic medical records. Based on the CDC guideline, patients were categorized to underweight, normal, overweight, and obese groups. Analysis of Variance was used to exam the effect of BMI category on neurocognitive outcomes. Spearman correlations examined the correlation between BMI z scores, neurocognitive performance, and eGFR at 1 and 5 years.
Results
The mean age at the time of neuropsychological evaluation was 11.7 years (SD=3.6). The mean age at kidney transplant was 13.3 (SD=3.6). The mean BMI z score was 0.2 (SD=1.2). Within the 75 patients, 7 (9.3%) were underweight, 45 (60.0%) were normal, 12 (16%) were overweight, and 11 (14.7%) were obese. There was a significant effect of BMI category on Working Memory performance (F(3)=2.82, p=0.045). Patients with normal BMI had higher Working Memory performance than patients who were underweight or overweight. There was no significant effect of BMI category on other neurocognitive outcomes (p values ranged from 0.197 to 0.60). Pre-transplant BMI z scores were not significantly associated with eGFR at 1 year or 5 years post-transplant.
Conclusion
Our study found that pre-transplant body mass index (BMI) was associated with pre-transplant working memory in pediatric kidney transplant candidates. The findings highlight the importance of a multidisciplinary approach to managing medical and neurocognitive factors to ensure optimal outcomes in this population.