Grosso G, Corona D, Mistretta A, Zerbo D, Sinagra N, Giaquinta A, Caglià P, Amodeo C, Leonardi A, Gula R, Veroux P, Veroux M
Department G.F. Ingrassia, Section of Hygiene and Public Health, University Hospital of Catania, Catania, Italy.
Transplant Proc. 2012 Sep;44(7):1864-8. doi: 10.1016/j.transproceed.2012.06.043.
The number of obese kidney transplant candidates has been growing. However, there are conflicting results regarding to the effect of obesity on kidney transplantation outcome. The aim of this study was to investigate the association between the body mass index (BMI) and graft survival by using continuous versus categoric BMI values as an independent risk factor in renal transplantation.
We retrospectively reviewed 376 kidney transplant recipients to evaluate graft and patient survivals between normal-weight, overweight, and obese patients at the time of transplantation, considering BMI as a categoric variable.
Obese patients were more likely to be male and older than normal-weight recipients (P = .021; P = .002; respectively). Graft loss was significantly higher among obese compared with nonobese recipients. Obese patients displayed significantly lower survival compared with nonobese subjects at 1 year (76.9% vs 35.3%; P = .024) and 3 years (46.2% vs 11.8%; P = .035).
Obesity may represent an independent risk factor for graft loss and patient death. Careful patient selection with pretransplantation weight reduction is mandatory to reduce the rate of early posttransplantation complications and to improve long-term outcomes.
肥胖的肾移植候选者数量一直在增加。然而，关于肥胖对肾移植结果的影响存在相互矛盾的结果。本研究的目的是通过将连续和分类的体重指数（BMI）值作为肾移植中的独立危险因素，来研究BMI与移植物存活之间的关联。
我们回顾性分析了376例肾移植受者，将BMI作为分类变量，评估移植时体重正常、超重和肥胖患者的移植物和患者存活率。
肥胖患者比体重正常的受者更可能为男性且年龄更大（分别为P = 0.021；P = 0.002）。与非肥胖受者相比，肥胖患者的移植物丢失显著更高。肥胖患者在1年（76.9%对35.3%；P = 0.024）和3年（46.2%对11.8%；P = 0.035）时的存活率显著低于非肥胖患者。
肥胖可能是移植物丢失和患者死亡的独立危险因素。必须在移植前仔细选择患者并减轻体重，以降低移植后早期并发症的发生率并改善长期结局。
