BMI and the Risk of Graft and Patient Failure in Kidney Transplantation

New Orleans—Previous studies in kidney transplant recipients with high body mass index (BMI) have yielded conflicting results; some studies reported inferior outcomes compared with patients with lower BMI and others reported superior outcomes in patients with high BMI compared with lower BMI. Whether BMI is a significant independent risk factor for graft failure and patient death in the modern immunosuppressive era is unclear.

Ho Sik Shin, MD, and Anil K. Chandraker, MD, recently conducted a study designed to examine whether obesity affects patient and graft outcome following kidney transplantation. Results were reported during a poster session at Kidney Week 2017 in a poster titled Is Body Mass Index a Significant Independent risk Factor for Graft Failure and Patient Death in the Modern Immunosuppressive Era?

The researchers utilized data from the United Network for Organ Sharing to identify patients who underwent primary kidney-only transplantation between 1987 and 2016. The study sample for the current analysis included 69,749 patients from 1987-1999 and 197,986 from 2000-2016. To evaluate the independent effect of BMI on graft and patient survival, the researchers correlated BMI with graft and patient survival, and created multivariate models, adjusting for factors known to affect graft success and patient survival.

In 1987-1999, mean BMI was 25 kg/m2; in 2000-2016, mean BMI was 27 kg/m2. There was an association between higher BMI and significantly worse graft, patient, and patient with functioning graft survival from 1987-1999. In the period 2000-2016, there was also an association between lower and higher BMI with significantly worse graft, patient, and patient with functioning graft survival.

In the same BMI group, graft and patient survival rates from 2000-2016 were higher than in 1987-1999. Cox regression modeling hazard ratios showed that obesity also increased the risk of graft failure and patient death.

In conclusion, the researchers said, “BMI is a significant independent risk factor for graft failure and patient death in the modern immunosuppressive era.”

Source: Shin HO, Chandraker AK. Is body mass index a significant independent risk factor for graft failure and patient death in the modern immunosuppressive era? Abstract of a poster presented at the American Society of Nephrology 2017 Kidney Week, November 2, 2017, New Orleans, Louisiana.