Key result
Obesity in kidney transplant recipients is linked to ~160% higher risk of delayed graft function.
Why the study?
The study was conducted to analyze the effects of obesity on postoperative complications and patient and graft survival following kidney transplantation.
Does obesity increase the risk of postoperative complications and reduce graft or patient survival in patients undergoing kidney transplantation?
Cohort
Does obesity increase the risk of postoperative complications and reduce graft or patient survival in patients undergoing kidney transplantation?
Hazard Ratio: 2.6 (95% CI 1.31–5.02)
p-value: p=.004
In kidney transplant recipients, obesity is associated with an increased risk of delayed graft function and graft loss, but does not significantly impact surgical complications or overall patient survival.
May guide risk counseling for obese kidney transplant candidates; leaves open whether pre-transplant weight loss improves graft survival.
OBJECTIVE: The objective of this study was to analyze the effects of obesity on postoperative complications and patient and graft survival after kidney transplantation. METHODS: based on World Health Organization criteria. Using univariate and multivariate analyses, we evaluated the impact of obesity on surgical complications according to the Clavien-Dindo classification up to 30 days after surgery. The impact of obesity on graft and patient survival was assessed using a Cox proportional regression model. RESULTS: Seventy-one patients were obese (14%), and mean follow-up was 63.1 months (59.7-66.5). By multivariable analysis, obesity was associated with delayed graft function (hazard ratio [HR] = 2.60 [1.31-5.02], P = .004). Obesity was not associated with surgical complications, but cardiovascular history was (HR = 1.68 [1.09-2.99], P = .048). By Cox regression analysis, obesity was significantly associated with a higher risk of graft loss (HR = 1.55 [1.06-2.99], P = .042) but not with patient survival (HR = 1.82 [0.88-3.79], P = .106). CONCLUSION: Obesity was associated with delayed graft function and graft loss. However, it was not associated with surgical complications. Kidney transplantation remains the best therapy for obese patients suffering from end-stage renal disease, despite shorter graft survival.
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Fellmann et al. (2020) conducted a cohort in End-stage renal disease. Obesity vs. Non-obese patients was evaluated on Delayed graft function (HR 2.60, 95% CI 1.31-5.02, p=.004). Obesity in kidney transplant recipients was significantly associated with delayed graft function (HR 2.60; 95% CI 1.31-5.02; P=.004) and a higher risk of graft loss (HR 1.55; 95% CI 1.06-2.99; P=.042).
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