Body mass index as a predictive factor for long-term renal transplant outcomes in Asians.
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.
Chow
Kai Ming
KM
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
Szeto
Cheuk Chun
CC
Leung
Chi Bon
CB
Lui
Siu Fai
SF
Tong
Yuen Fan
YF
Li
Philip Kam-Tao
PK
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
D003404:Creatinine