@article{5a5d800b6cdb41fdb0ddd3356ca26aab,
title = "Associations of obesity with antidiabetic medication use after living kidney donation: An analysis of linked national registry and pharmacy fill records",
abstract = "We examined a novel linkage of national US donor registry data with records from a pharmacy claims warehouse (2007-2016) to examine associations (adjusted hazard ratio, LCLaHRUCL) of post-donation fills of antidiabetic medications (ADM, insulin or non-insulin agents) with body mass index (BMI) at donation and other demographic and clinical factors. In 28 515 living kidney donors (LKDs), incidence of ADM use at 9 years rose in a graded manner with higher baseline BMI: underweight, 0.9%; normal weight, 2.1%; overweight, 3.5%; obese, 8.5%. Obesity was associated with higher risk of ADM use compared with normal BMI (aHR, 3.364.596.27). Metformin was the most commonly used ADM and was filled more often by obese than by normal weight donors (9-year incidence, 6.87% vs 1.85%, aHR, 3.555.007.04). Insulin use was uncommon and did not differ significantly by BMI. Among a subgroup with BMI data at the 1-year post-donation anniversary (n = 19 528), compared with stable BMI, BMI increase >0.5 kg/m2 by year 1 was associated with increased risk of subsequent ADM use (aHR, 1.031.482.14, P =.04). While this study did not assess the impact of donation on the development of obesity, these data support that among LKD, obesity is a strong correlate of ADM use.",
keywords = "antidiabetic medications, diabetes mellitus, health outcome, living donation, pharmacy claims, registries",
author = "Lentine, {Krista L.} and Koraishy, {Farrukh M.} and Nagaraju Sarabu and Naik, {Abhijit S.} and Lam, {Ngan N.} and Garg, {Amit X.} and David Axelrod and Zidong Zhang and Hess, {Gregory P.} and Kasiske, {Bertram L.} and Segev, {Dorry L.} and Henderson, {Macey L.} and Massie, {Allan B.} and Holscher, {Courtenay M.} and Schnitzler, {Mark A.}",
note = "Funding Information: Funding information This work was conducted under the auspices of the Hennepin Healthcare Research Institute (HHRI), contractor for the Scientific Registry of Transplant Recipients (SRTR), as a deliverable under contract no. HHSH250201500009C (US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation). As a US Government-sponsored work, there are no restrictions on its use. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government. Supported in part by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases, R01-DK096008. NNL was supported by a KRESCENT New Investigator Award. The authors thank SRTR colleague Nan Booth, MSW, MPH, ELS, for manuscript editing. An abstract describing portions of this work was an “Abstract of Distinction” at the American Transplant Congress 2017, Chicago, IL, and highlighted by Renal & Urology News, https://bit.ly/2pmCvFj. Publisher Copyright: {\textcopyright} 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",
year = "2019",
month = oct,
day = "1",
doi = "10.1111/ctr.13696",
language = "English (US)",
volume = "33",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "10",
}