The Role of Obesity in Kidney Transplantation Outcome

Background. The number of obese kidney transplant candidates has been growing.However, there are conflicting results regarding to the effect of obesity on kidneytransplantation outcome. The aim of this study was to investigate the association betweenthe body mass index (BMI) and graft survival by using continuous versus categoric BMIvalues as an independent risk factor in renal transplantation.Methods. We retrospectively reviewed 376 kidney transplant recipients to evaluate graftand patient survivals between normal-weight, overweight, and obese patients at the time oftransplantation, considering BMI as a categoric variable.Results. Obese patients were more likely to be male and older than normal-weightrecipients (P .021; P .002; respectively). Graft loss was significantly higher amongobese compared with nonobese recipients. Obese patients displayed significantly lowersurvival compared with nonobese subjects at 1 year (76.9% vs 35.3%; P .024) and 3 years(46.2% vs 11.8%; P .035).Conclusions. Obesity may represent an independent risk factor for graft loss and patientdeath. Careful patient selection with pretransplantation weight reduction is mandatory toreduce the rate of early posttransplantation complications and to improve long-termoutcomes.