*Purpose: BMI has an effect on patients with chronic kidney disease (CKD) and after kidney transplantation (ktx). Higher body weight and use of immunosuppressive treatment increases the risk of development of post transplantation diabetes mellitus (PTDM), which independently worsens the prognosis.

The aim of this study was to evaluate the association between patients BMI and long-term graft and recipient survival.

*Methods: 80 patients (50M; 30F) with stable kidney transplant function (min. 12mths after ktx) were included in the study. The study was also created to compare prognostic value of 19 patients with diabetic nephropathy preceding transplant, and patients with PTDM (n=28). The follow-up period was 8 yrs. Combined end-point was return to dialysis and/or death. At the beginning of the study average time for transplantation was 7.13yrs (range 1-21) and the recipient age 51.15yrs (range 23-71). The data, anthropometric values and laboratory results were obtained during 12mth intervals. Selected inflammatory cytokines were measured additionally at the beginning of the study.

*Results: The full follow-up period was completed by 51 patients. 10 patients died, and 19 were transferred to dialysis (36.2%, n=29). The group of patients with complications had statistically higher BMI at the beginning of observation (28.7vs.26.5kg/m²; p=0.034). The proportion of patients with obesity and overweight were also higher – respectively 40.7vs.25.5% and 81.5vs.54.9%. Initially patients with BMI over 25kg/m² were characterized by significantly higher values of TNF RII (p=0.043), IL-6hs (p=0.011). Patients with PTDM were characterized by statistically higher BMI (29.8vs.26kg/m²; p=0.033). In the group of patients without combined end-point we observed stable BMI values. During the 8 yrs of observation the average BMI value was in the range of 26.27-26.72kg/m², despite the serum creatinine level in this group increased during the observation (112.5vs.126.3vs.158.2µmol/l – respectively after 4 and 8 yrs;p<0.05).

*Conclusions: Obesity and overweight is connected with worse recipient and graft survival in the advanced post-ktx period. Higher BMI can activate the inflammatory response of the organism. The cause-effect relationship between BMI and complications after ktx in later periods is unclear. Patients with stable BMI despite worsening of the graft function had much less significant complications, which included death and transfer to dialysis.

« Back to 2019 American Transplant Congress