Posttransplant overweight and obesity: myth or reality?

Transplant Proc. 2007 Nov;39(9):2772-5. doi: 10.1016/j.transproceed.2007.09.001.

Abstract

Posttransplant body mass index (BMI) increase in kidney transplant recipients is an underestimated issue, predisposing to morbidity linked with development of polymetabolic syndrome.

Aim: The aim of the study was to assess the incidence of overweight and obesity among endstage renal disease patients before and after kidney transplantation.

Material: Four hundred eighteen kidney graft recipients were enrolled in the study which lasted a mean of 56 months. Inhabitants of Lower Silesia (n = 3855) were used as controls. Overweight was defined as BMI between 25 and 30 kg/m(2) and obesity as >30 kg/m(2).

Methods: Mean BMI calculated in 418 patients, both pretransplant and after a 4.5-year observation period was compared with results of the Lower Silesian population.

Results: Mean pretransplant BMI in men (n = 242) and women (n = 189) was lower than in controls: men pretransplant BMI 24.3 kg/m(2) versus 25.7 kg/m(2) in the normal population; women, pretransplant BMI 23.17 kg/m(2) versus 25.2 kg/m(2) in the control group respectively. Mean total pretransplant BMI values increased from 23.82 to 25.9 kg/m(2) at last checkup ("last BMI"). A lesser posttransplant BMI increase was noted in men (7%) compared with women (9.6%). Before transplant, overweight or obesity occurred in 38% (n = 157), after a 4.5-year observation period, 65% (n = 232).

Conclusions: Our observations documented that obesity is a widespread issue in kidney graft recipients, affecting two thirds of the population. It should be the target of preventive measures and nonpharmacologic therapeutic interventions.

MeSH terms

  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Graft Rejection / physiopathology
  • Humans
  • Incidence
  • Kidney Transplantation / adverse effects*
  • Male
  • Multivariate Analysis
  • Obesity / epidemiology*
  • Overweight / epidemiology*
  • Regression Analysis
  • Reproducibility of Results
  • Time Factors
  • Weight Gain