Higher BMI is associated with an increased risk of renal graft loss in Asian transplant recipients, researchers in Hong Kong report.


They found that graft loss was nearly five times as likely to occur in overweight patients (BMI of

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25 kg/m2 or higher) than in those with a lower BMI.


The study, conducted at the Prince of Wales Hospital, involved 150 Chinese renal transplant recipients, of whom 37 were considered overweight and 113 were not. After a median follow-up of nine years, 15 graft losses (41%) occurred in the overweight group compared with 14 (12%) in the other group.


Five-year cumulative graft survival was significantly worse in the overweight patients (83.6% vs. 92.7%). At 10 years, the overweight patients had a lower event-free survival rate (62.8% vs. 80.4%). Death with a functioning graft occurred in 11% of the overweight patients compared with 3% in the other patients. In addition, the overweight patients were three times more likely to have a doubling of serum creatinine.


Despite limitations such as a relatively small sample size and the focus on patients at a single center, the researchers, led by Kai Ming Chow, MD, concluded that their study “draws attention to a relatively undefined body mass index cut-off in Asian kidney transplant populations, and provides clues as to what would be considered a desirable body mass index for this ethnic group.”


It remains unclear whether weight loss in potential overweight transplant recipients or intentional weight loss following transplantation improves overall graft survival, the researchers pointed out. “Nonetheless, it seems prudent to consider a more stringent body mass index cut-off of 25 kg/m2

for the purpose of risk stratification in Asian population.”