Skip Navigation LinksHome > January 15, 2014 - Volume 97 - Issue 1 > Increased Recipient Body Mass Index Is Associated With Acute...
doi: 10.1097/TP.0b013e3182a688a4
Clinical and Translational Research

Increased Recipient Body Mass Index Is Associated With Acute Rejection and Other Adverse Outcomes After Kidney Transplantation

Curran, Simon P.1; Famure, Olusegun1; Li, Yanhong1; Kim, S. Joseph1,2,3

Supplemental Author Material
Collapse Box


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.

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/m2. Potential confounders were included in logistic and Cox proportional hazards models.

Results: A total of 1151 patients were studied. Recipient BMI of 30 to 34.9 and ≥35 kg/m2 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/m2 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.

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.

© 2014 by Lippincott Williams & Wilkins



Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.