title: [Is obesity a barrier to kidney transplantation?].
abstract: BACKGROUND
  Kidney transplantation is the most suitable of ESRD care. The proportion of obese people is increasing in the general population and patients with kidney impairment. It is important to assess the impact of obesity on surgical complications of kidney transplantation. The aim of this retrospective study was to signify the correlation between obesity and the occurrence of postoperative urological complications during the first year.
  
  
  METHODS
  We conducted a retrospective study from March 1999 to December 2009. We conducted a chart review of patients undergoing kidney transplantation. The kidneys were taken from cadaveric donors. Data collected included age, weight, height, preoperative BMI; causal nephropathy, smoking, hypertension, diabetes, anticoagulation therapy. Intraoperative data included operative time (DO), cold ischemia. Urological complications were recorded during the first year after the kidney transplantation (vascular anastomotic strictures, ureterovesical stenosis, lymphorrheas, pyelonephritis, hematoma, wound infection). Statistical analysis consisted of a t-test for independent samples and univariate and multivariate logistic regression for the occurrence of complications.
  
  
  RESULTS
  Four hundred and twenty-two patients were transplanted in total. We excluded 20 patients. BMI and duration of surgery patients with complications were significantly different from those of patients with no complications (P=0.016 and P=0.039, respectively). Obese (n=48) had more diabetes (12.5% versus 3.7%, P=0.014), were more often smoking (35.4% versus 22%, P=0.012), had a longer DO (203.64minutes versus 182.46minutes, P=0.006), and complications (62.5% versus 50.28%, P=0.03) than patients with a BMI <30 (n=354). After adjusting for age, smoking, DO, diabetes and BMI showed that only BMI was an independent predictor of the occurrence of postoperative complications with P=0.048 and RR=1.058 [CI: 1 to 1.119]. However, there was no more transplantectomy obese (P=0.911).
  
  
  CONCLUSIONS
  Our study showed that there is a significant risk of surgical complications after kidney transplantation in obese patients. But ultimately, this does not affect graft survival because there are no more transplantectomies or return to dialysis.
  
  
  METHODS
  5.
authors.affiliation: Service d'urologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51100 Reims, France. Electronic address: lisegant@hotmail.com.
authors.forename: M L
authors.initials: ML
authors.lastname: Kamdoum Nanfack
authors.affiliation: Service d'urologie, hôpital du Val-de-Grace, 74, boulevard du Port-Royal, 75230 Paris cedex 05, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Bayoud
authors.affiliation: Service d'urologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51100 Reims, France.
authors.forename: C
authors.initials: C
authors.lastname: Marchand
authors.affiliation: Service d'urologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51100 Reims, France.
authors.forename: I
authors.initials: I
authors.lastname: Cholley
authors.affiliation: Service d'urologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51100 Reims, France.
authors.forename: P
authors.initials: P
authors.lastname: Leon
authors.affiliation: Service d'urologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51100 Reims, France.
authors.forename: R
authors.initials: R
authors.lastname: Fournier
authors.affiliation: Service d'urologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51100 Reims, France.
authors.forename: T
authors.initials: T
authors.lastname: Lassere
authors.affiliation: Service d'urologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51100 Reims, France.
authors.forename: S
authors.initials: S
authors.lastname: Larre
mesh_terms: D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology
keywords: Complications; Facteurs prédictifs; Obesity; Obésité; Predictors; Renal transplantation; Retour en dialyse; Return to dialysis; Survie; Survival; Transplantation rénale; Transplantectomie; Transplantectomy