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Increased recipient body mass index is associated with acute rejection and other adverse outcomes after kidney transplantation.
- Source :
-
Transplantation [Transplantation] 2014 Jan 15; Vol. 97 (1), pp. 64-70. - Publication Year :
- 2014
-
Abstract
- Background: Outcomes of kidney transplant recipients with increased body mass index (BMI) remain controversial. We studied the relationship between BMI and clinically relevant outcomes among kidney transplant recipients at a large center.<br />Methods: We performed an observational cohort study of all recipients of kidney transplants at our center from January 1, 2000 to December 31, 2010 to determine if increased BMI at transplantation is associated with adverse outcomes, including delayed graft function and biopsy-proven acute rejection (BPAR). Recipient BMI was categorized as <20, 20 to 24.9 (reference), 25 to 29.9, 30 to 34.9, and ≥35 kg/m. Potential confounders were included in logistic and Cox proportional hazards models.<br />Results: A total of 1151 patients were studied. Recipient BMI of 30 to 34.9 and ≥35 kg/m were associated with an increased risk of delayed graft function (odds ratio [95% confidence interval [CI], 1.92 [1.16-3.19] and 4.49 [2.24-9.00], respectively). BMI≥35 kg/m was also associated with an increased risk of BPAR (hazard ratio [HR; 95% CI], 2.43 [1.48-3.99]), all-cause graft failure (HR [95% CI], 1.97 [1.09-3.56]), and death-censored graft failure (HR [95% CI], 2.43 [1.07-5.51]). Adjustment for acute rejection as a time-varying covariate significantly attenuated the association with graft failure endpoints. There was no significant relation between BMI and death with graft function.<br />Conclusions: Increased BMI at kidney transplantation is a predictor of adverse outcomes, including BPAR. The role of pretransplantation weight reduction in improving graft and patient outcomes requires further study.
- Subjects :
- Acute Disease
Adult
Aged
Biopsy
Delayed Graft Function etiology
Female
Graft Rejection pathology
Graft Survival
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Multivariate Analysis
Obesity diagnosis
Odds Ratio
Ontario
Proportional Hazards Models
Risk Factors
Time Factors
Treatment Outcome
Body Mass Index
Graft Rejection etiology
Kidney Transplantation adverse effects
Obesity complications
Subjects
Details
- Language :
- English
- ISSN :
- 1534-6080
- Volume :
- 97
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 24056619
- Full Text :
- https://doi.org/10.1097/TP.0b013e3182a688a4