Obese Patients Can Still Benefit From Kidney Transplants
July 29, 2013

Kidney Transplants Also Benefit Obese Patients, According To New Study

redOrbit Staff & Wire Reports - Your Universe Online

Obese kidney failure patients who receive transplants experience the same overall survival benefit as their more physically fit counterparts, according to new research appearing in the latest edition of the American Journal of Transplantation.

According to MedPage Today Contributing Writer Salynn Boyles, the study authors discovered renal failure patients who are obese but have a body mass index (BMI) score under 40kg/m2 experience an average 66 percent reduction in the risk of death one year after undergoing transplant surgery.

That's the same one-year death-rate decrease as non-obese patients, University of British Columbia professor Dr. John Gill and his colleagues explained in their study. Furthermore, they found the death rate among patients who had been placed on transplant wait lists was similar for both obese and non-obese patients, added Boyles.

"This is good and important news with the changing environment and increasing regulation of transplantation. It confirms the benefit of transplantation in this high-risk group," Dr. Gill, the study's senior author, said in an interview with Andrew M. Seaman of Reuters Health on Friday.

"We know that obesity is associated with more complications and an overall survival disadvantage following transplant," he told Boyles. "But when you look at the relative benefit an obese person gets from transplant compared to staying on dialysis, it is of the same magnitude as what a leaner person would get."

Previous studies have shown obese kidney failure patients respond better to dialysis than thinner individuals, but they were more likely to die following organ transplants, Seaman said. The US Centers for Disease Control and Prevention (CDC) considers any adult man or woman with a BMI score - which is the measure of a person's weight relative to his or her height - of at least 30 to be obese.

"The most recent previous analysis of kidney transplants in obese patients found their survival benefit is comparable to that of thinner patients, but the result was based on data from the 1990s," the Reuters reporter added. "Since then, according to the researchers, the number of obese people with end-stage kidney disease has grown and the selection of transplant patients has evolved."

During their research, Gill and colleagues reviewed data on American adults suffering from end-stage kidney disease, all of whom had either received a transplant or had started dialysis between April 1995 and September 2007.

Approximately 60 percent of the non-obese patients received a transplant, compared to about half of the obese ones, Seaman said. Amongst thinner patients, 12 percent of transplant recipients and 34 percent of dialysis patients died within approximately three years time. In comparison, 14 percent of obese transplant recipients and 28 percent of obese dialysis patients passed away after at the end of the same time period.

However, the researchers also discovered severely obese patients (those with BMIs scores of 40 or higher) did not respond as well. They only experienced a 48 percent reduction in death risk after one year, Boyles said. Furthermore, it could not be determined whether African Americans with a BMI over 40 received any benefit, as the researchers said too few of the racial subset took part in the study.