open access

https://hdl.handle.net/2115/71315

Body Mass Index Impact on the Long-Term Outcome after Kidney Transplantation in Japanese Patients

英語

BMI

2017

Insight Medical Publishing

Journal of Nephrology and Urology

1(2)

8

We appreciate the support provided by Kota Ono, MPH. (Translational research and clinical trial center, Hokkaido University Hospital, Japan), who provided expert assistance with statistical analysis. His contribution was involved in the study design, patient enrollment, data collection, analysis, interpretation or preparation of the manuscript. (Kota Ono, Hokkaido University, Department of Biostatistics, Graduate School of Medicine (Hokkaido University Hospital, Clinical Research and Medical Innovation Center, Biostatistics Division))

Objective: While high BMI has negative impact on patients with acute or chronic kidney disease, low BMI is related to mal-nutrition and poor survival in patients on dialysis. On the other hand, pretransplant medical policy recommends recipients to improve their overweight status in order to prevent postoperative surgical complications. We investigated how pretransplant BMI influence postoperative course in Japanese end-stage renal disease patients. Patients and methods: We reviewed 219 patients who underwent kidney transplantation between 1986 and 2014 at our institution. Pediatric recipients (age<20) were excluded. We divided the recipients into 4 groups by BMI (under 18.5, 18.5-21.9, 22.0-24.9, over 25.0). Postoperative complications (wound related and infectious adverse events), allograft rejection, and allograft survival were investigated among the BMI groups. Results: Post-transplant infectious disease was more frequent (5 in 27 cases: 18.5%) in over 25.0 group than any of other BMI groups (0 to 2.1%, p=0.006). Ten year allograft survival rate of over 25.0 group was inferior to that of under 18.5 group (p=0.037). Meanwhile, BMI over 25.0 did not impair graft survival compared to other factors (age, preemptive transplantation, ABO blood type incompatibility and mycophenolate mofetile utilization) in Cox proportional hazards analysis. Conclusion: Overweight (BMI>25.0) in Japanese kidney recipients might affect post-transplant infectious disease occurrence; however, it is not a deteriorating factor for long-term allograft survival.

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