Retrospective analysis of the impact of severe obesity on kidney transplant outcomes. Issue 2 (7th May 2022)

• Record Type: Journal Article
• Authors: Tsapepas, Demetra; Sandra, Vanessa; Dale, Leigh Ann; Drexler, Yelena; King, Kristen L; Yu, Miko; Toma, Katherine; Van Bever, Jennifer; Sanichar, Navin; Husain, S Ali; Mohan, Sumit
• Is Part Of: Nephrology dialysis transplantation. Volume 38:Issue 2(2023)
• Page Start: 472
• Page End: 480
• Publication Date: 2022-05-07
• Subjects: kidney transplantation -- morbid obesity -- severe obesity -- surgical complications -- transplant outcomes; Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfac169
• Languages: English
• ISSNs: 0931-0509

Abstract

ABSTRACT: Background: The prevalence of obesity among kidney transplant recipients is rising. We sought to determine the association between recipient body mass index (BMI) and post-transplant complications. Methods: Single-center, retrospective cohort study of all adult kidney transplant recipients from 2004 to 2020. Recipients were stratified into four BMI categories: normal-weight (BMI 18.5–24.9 kg/m 2, n = 1020), overweight (BMI 25–29.9 kg/m 2, n = 1002), moderately obese (BMI 30–34.9 kg/m 2, n = 510) and severely-to-morbidly obese (BMI ≥35 kg/m 2, n = 274). Logistic regression was used to estimate the association between BMI category and surgical site infections (SSIs). Results: Recipients with BMI ≥35 kg/m 2 had significantly higher rates of SSIs ( P < .0001) compared with recipients in all other categories. On multivariable analysis, recipients with BMI ≥35 kg/m 2 had increased odds of SSIs compared with normal-weight recipients [odds ratio (OR) 3.34, 95% confidence interval (CI) 1.55–7.22, P = .022). On multivariable and Kaplan–Meier analyses, no BMI groups demonstrated increased odds for death-censored graft failure. Conclusion: Severe obesity in kidney transplant recipients is associated with increased SSIs, but not kidney allograft failure. Graphical Abstract: