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Body mass index as a predictive factor for long‐term renal transplant outcomes in Asians
Author(s) -
Chow Kai Ming,
Szeto Cheuk Chun,
Leung Chi Bon,
Lui Siu Fai,
Tong Yuen Fan,
Li Philip KamTao
Publication year - 2006
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2006.00520.x
Subject(s) - medicine , overweight , body mass index , proportional hazards model , population , risk factor , survival analysis , relative risk , obesity , creatinine , surgery , confidence interval , environmental health
Background: There is substantial evidence that renal transplant recipients with obesity or body mass index >30 kg/m 2 have increased risk of graft loss. However, few data exist for Asian population; clinicians have to rely upon indirect evidence by extrapolating the results from Caucasians to Asian recipients. Study: Using data from a study population of 150 consecutive cadaveric or living related Chinese renal transplant recipients at our center between 1985 and 2002, we examined the effect of baseline body mass index cut‐off 25 kg/m 2 on the transplant outcomes using Kaplan–Meier analysis and Cox proportional hazards analysis. Primary study end point was overall graft survival. Results: The mean body mass index was 22.9 ± 4.0 kg/m 2 . Thirty‐seven (25%) patients were classified as overweight and 113 patients as non‐overweight, using the cut‐off of 25 kg/m 2 . After median follow up period of nine yr, 15 graft losses (41%) occurred in the overweight group, as compared with 14 graft losses (12%) in the non‐overweight group. Kaplan–Meier estimates of cumulative graft survival at five yr were significantly worse for the overweight group than non‐overweight group (83.6% versus 92.7%, p = 0.0041). By multivariate Cox proportional hazards analysis, baseline body mass index ≥25 kg/m 2 conferred a significantly higher risk of graft loss (with relative risk of 4.78, 95% CI = 1.52–15.2) and doubling of serum creatinine (relative risk 3.19, 95% CI = 1.22–8.40). Death with a functioning graft occurred in 11% of overweight recipients, compared with 3% among the non‐overweight group (p = 0.041). Conclusion: Our results draw attention to a recipient body mass index cut‐off value ≥25 kg/m 2 , which might confer an increased risk of graft loss in Asian kidney transplant populations.