title: Body mass index as a predictive factor for long-term renal transplant outcomes in Asians.
abstract: 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.
  
  
  METHODS
  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 > or =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).
  
  
  CONCLUSIONS
  Our results draw attention to a recipient body mass index cut-off value > or =25 kg/m(2), which might confer an increased risk of graft loss in Asian kidney transplant populations.
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. chow_kai_ming@alumni.cuhk.net
authors.forename: Kai Ming
authors.initials: KM
authors.lastname: Chow
authors.forename: Cheuk Chun
authors.initials: CC
authors.lastname: Szeto
authors.forename: Chi Bon
authors.initials: CB
authors.lastname: Leung
authors.forename: Siu Fai
authors.initials: SF
authors.lastname: Lui
authors.forename: Yuen Fan
authors.initials: YF
authors.lastname: Tong
authors.forename: Philip Kam-Tao
authors.initials: PK
authors.lastname: Li
mesh_terms: D044466:Asian People; D015992:Body Mass Index; D002681:China; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D016896:Treatment Outcome
chemical_list: D003404:Creatinine