title: Pre-transplant overweight and obesity do not affect physical quality of life after kidney transplantation.
abstract: BACKGROUND
  Recent studies demonstrate that obesity does not affect survival after kidney transplantation. However, overweight and obesity impair health-related quality of life (HRQOL) in patients with chronic illnesses. We wished to examine the effects of pre-transplant overweight and obesity on post-transplant physical HRQOL in kidney transplant recipients.
  
  
  METHODS
  Patient-reported HRQOL data were systematically collected in kidney transplant recipients receiving post-transplant follow-up at Vanderbilt Transplant Center. Patients who received kidney transplants between 1998 and 2008, had at least 1 post-transplant physical component summary (PCS) measurement, and did not receive other solid organ transplants were included in this retrospective cohort study. Pre-transplant body mass index was stratified as normal, overweight, obese class I, and obese class II/extremely obese. HRQOL was measured primarily with the PCS scale of the Medical Outcomes Study Short Form 36 Health Survey. Multivariate linear and logistic regression models were used to test the effects of body mass index and demographic and clinical covariates on post-transplant HRQOL.
  
  
  RESULTS
  The study cohort included 464 adults (mean body mass index 27.5 +/- 5.1; range 18.5 to 47.4). After controlling for gender (p = 0.148), pre-transplant dialysis (p = 0.003), previous kidney transplantation (p = 0.255), donor type (p = 0.455), steroid avoidance immunosuppression (p = 0.070), and follow-up time (p = 0.352), there was no effect of pre-transplant overweight or obesity on post-transplant PCS (all p > or = 0.112). Kidney transplant recipients who did not require dialysis pre-transplant and those who were managed with steroid avoidance after transplantation were more likely to achieve post-transplant PCS scores at or above the general population average (both p < or = 0.011).
  
  
  CONCLUSIONS
  Pre-transplant overweight and obesity do not affect physical quality of life after kidney transplantation.
authors.affiliation: Department of Surgery and Vanderbilt Transplant Center, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA. vic.zaydfudim@vanderbilt.edu
authors.forename: Victor
authors.initials: V
authors.lastname: Zaydfudim
authors.forename: Irene D
authors.initials: ID
authors.lastname: Feurer
authors.forename: Deonna R
authors.initials: DR
authors.lastname: Moore
authors.forename: Derek E
authors.initials: DE
authors.lastname: Moore
authors.forename: C Wright
authors.initials: CW
authors.lastname: Pinson
authors.forename: David
authors.initials: D
authors.lastname: Shaffer
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D006304:Health Status; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires