Is Overweight a Relevant Risk Factor in the Short and Long-Term Evolution of Renal Transplantation?

Abstract

Obesity is a known risk factor in big epidemiological population-based studies. There is some evidence that obesity is related to worse patient and graft survival in kidney transplantation, but little is known about the relevance of more moderate overweight. Influence of overweight on patient and graft survival and on associated morbidity was assessed in 562 patients older than 15 years that received a cadaveric renal transplantation since 1.979. Mean follow-up was 58 months. Overweight [Body Mass Index (BMI) 25–30 kg/m2] was noted in 115 patients (Group 1) and normal weight (BMI <25 kg/m2) in 447 (Group 2). Age was higher in Group 1 than in Group 2 (46.6±10 vs 36.8±12 yr, p<0.01). Donor age and sex, HLA-A-B-DR matching, cold and warm ischemia times were similar in both groups. Delayed graft function was more frequent in the overweight patients (47 vs 35%, p<0.05). Overall incidence of acute rejection was slightly lower in Group 1 (52 vs 60%, NS). One-year graft survival was similar in both groups [78.3% (n=90) vs 78% (n=341) respectively, NS], as was five-year graft survival [67% (n=42) vs 65% (n=189), NS]. Patient survival at one and five years was also similar. There were no differences in the appearance of surgical complications, diabetes, hyperlipemia or avascular osteonecrosis. Days of hospital admission during the first year post-transplantation were also similar between both groups (36.5±27.6 vs 39.7±31.3,NS). Serum creatinine (SCr) at the end of the first year was 132±44 µ/l in Group 1 and 160±88 µ/l in Group 2, NS. Five years post-transplantation, SCr was 132±44 and 132±62 µ/l, respectively, NS.