Abstract
BackgroundWhilst there are a number of publications comparing the relationship between body mass index (BMI) of kidney transplant recipients and graft/patient survival, no study has assessed this for a French patient cohort.MethodsIn this study, cause-specific Cox models were used to study patient and graft survival and several other time-to-event measures. Logistic regressions were performed to study surgical complications at 30 days post-transplantation as well as delayed graft function.ResultsAmong the 4691 included patients, 747 patients were considered obese with a BMI level greater than 30 kg/m2. We observed a higher mortality for obese recipients (HR = 1.37, p = 0.0086) and higher risks of serious bacterial infections (HR = 1.24, p = 0.0006) and cardiac complications (HR = 1.45, p < 0.0001). We observed a trend towards death censored graft survival (HR = 1.22, p = 0.0666) and no significant increased risk of early surgical complications.ConclusionsWe showed that obesity increased the risk of death and serious bacterial infections and cardiac complications in obese French kidney transplant recipients. Further epidemiologic studies aiming to compare obese recipients versus obese candidates remaining on dialysis are needed to improve the guidelines for obese patient transplant allocation.
Highlights
Whilst there are a number of publications comparing the relationship between body mass index (BMI) of kidney transplant recipients and graft/patient survival, no study has assessed this for a French patient cohort
Studied population Data were extracted from the French prospective DIVAT (Données Informatisées et VAlidées en Transplantation) cohort composed of kidney transplant recipients followed in Nantes, Paris (Necker and Saint-Louis), Montpellier, Nancy, Lyon, and Nice University Hospitals
Three thousand nine hundred forty-four patients were in the non-obese group (NOG, 84.1%) versus 747 in the obese group (OG, 15.9%)
Summary
Whilst there are a number of publications comparing the relationship between body mass index (BMI) of kidney transplant recipients and graft/patient survival, no study has assessed this for a French patient cohort. Obesity is defined by a body mass index (BMI) greater than or equal to 30 kg/m2. Obesity is associated with increased rates of cardiovascular diseases, diabetes, musculoskeletal disorders and cancer [2]. Obesity increases the risk for chronic kidney disease and its progression to End-Stage Renal Disease (ESRD) [3]. In the North-American patients, obesity rates have increased by 33% from 1995 to [4]. In France, the prevalence of obesity is around 21% in patients undergoing hemodialysis, whilst an increase in survival for ESRD patients with a high-level BMI have been reported [5, 6]
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