Triglyceride-glucose index and risk of renal function decline and death-censored renal allograft loss in kidney transplant recipients
- Author:
Hyo Jin LEE
1
;
Yu Ho LEE
;
Jin Sug KIM
;
Kyung Hwan JEONG
;
Jeong-Yeun LEE
;
Hye Eun YOON
;
Ki-Ryang NA
;
Dong Ryeol LEE
;
Jaeseok YANG
;
Myoung Soo KIM
;
Amy M. SITAPATI
;
Hyeon Seok HWANG
;
Author Information
- Publication Type:Original Article
- From:Kidney Research and Clinical Practice 2025;44(6):974-983
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Although insulin resistance is common, its significance in kidney transplant recipients remains unclear. We explored clinical implications of the triglyceride-glucose (TyG) index as a marker for unfavorable allograft outcomes in kidney transplant recipients.
Methods:A total of 6,354 kidney transplant recipients were enrolled in a multicenter prospective cohort study between May 2014 and December 2022. The TyG index was assessed between 6 and 12 months after transplantation. We evaluated the association between the TyG index and the risk of adverse kidney outcomes.
Results:The cumulative rates of ≥50% decline in estimated glomerular filtration rate (eGFR), death-censored graft survival, and major adverse kidney events differed across TyG index quartiles, with the highest rate observed in quartile 4 (p < 0.001). TyG index quartile 4 was associated with the highest risk of death-censored graft loss after multivariable adjustment (adjusted hazard ratio, 2.13; 95% confidence interval [CI], 1.28–3.55). The risk of ≥30% decline in eGFR was 1.46 times higher (95% CI, 1.17–1.82) in quartile 4 compared with quartile 1, and the risk of ≥50% decline was 1.78 times higher (95% CI, 1.30–2.44). Quartile 4 also showed a significantly steeper decline in renal function, with an adjusted mean difference in eGFR slope of –4.72 mL/min/1.73 m2 (95% CI, –7.39 to –2.04).
Conclusion:Kidney transplant recipients with high TyG index were at increased risk of eGFR decline and graft loss, and also exhibited a more rapid deterioration in renal function. The TyG index is a useful marker for identifying individuals at high risk for adverse graft outcomes.
