Ganho de peso após transplante renal em pacientes pediátricos: há influência do estado nutricional do cuidador?

• Ano de defesa: 2019
• Autor(a) principal: Fidalgo, Renata Lucats [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Child; Kidney Transplant; Obesity; Caregiver; Criança; Transplante Renal; Obesidade; Cuidador
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7937814; https://repositorio.unifesp.br/handle/11600/59825

Objective - The frequency of obesity in children has increased worldwide and the obesogenic environment is one of the factors suggested to explain this phenomenon. Children with chronic kidney disease have malnutrition, but after kidney transplantation (RTx) there is a significant gain in body mass. The aim of the present study is to test the existence of an association between caregiver overweight and pediatric patients weight gain in the first six months after RTx. Methods - Retrospective cohort study of a sample of children undergoing TxR from 2003 to 2017, including data up to 6 months after TxR in the ranges: M0 (closest to TxR), M3 (3rd month post TXR) and M6 (6th month post TXR). Receiver weight gain was the outcome variable and the caregiver's nutritional classification was considered as the exposure variable (binary variable representing presence or absence of caregiver overweight). Results - 96/299 (32%) of caregivers were not overweight (GI), while 203/299 (68%) were (GII). In M0, children from GII presented significantly higher BMI / I Z scores than children from GI (-0.26 ± 1.36 versus -0.63 ± 1.59, p = 0.039). The delta Z BMI score was not statistically different between groups, with GI = 0.6 (-0.1 - 1.2) and GII = 0.6 (0.1 - 1.1) respectively, p = 0.517. In the repeated measures analysis it was observed in the complete sample, statistically significant weight gain over time, but without difference between the groups. Conclusion - There is body mass gain in pediatric patients in the first 6 months after RTx. The obesogenic environment, represented by the caregiver's BMI, did not seem to play an important role in short-term mass gain. However, patients who have overweight caregivers have had a higher body mass transplantation, suggesting the influence of environmental factors on the body mass of children before transplantation.