Obesity and Kidney Transplantation

What I learned at the NKF 2010. Some key points

1. BMI < 18 and >30 are both associated with worsening graft survival
2. Why does obesity affect transplant outcomes: The risk factors after few studies have been: increased insulin resistance, increased BP, hyperlipidemia, increased proteinuria and development of NODAT

3. There has been a higher incidence of acute rejection in high BMI patients? The reason: obesity has been associated with mild continuous chronic inflammation and increased proteinuria.

4. Should obese patients be trasnplanted? Yes as a comparative study showing how they do on dialysis still shows they do better on transplant. Yes, when compared to non obese patients getting transplanted, the risk is low, the overall benefit vs dialysis is more.
5. Should their immunosuppresion be treated differently? No real headway. When compared steroid free vs steroid + protocols in obese patients, no difference was noted in outcomes.