http://www.ncbi.nlm.nih.gov/pubmed/23114900

Nephrol Dial Transplant. 2012 Oct;27(10):3732-5. doi: 10.1093/ndt/gfs406.

Transplantation in the obese: separating myth from reality.

Khwaja A, El-Nahas M.

Source

Correspondence and offprint requests to: Arif Khwaja; E-mail: arif.khwaja@sth.nhs.uk.

Abstract

The prevalence of obesity among patients requiring renal replacement therapy continues to increase inexorably. While observational data have suggested that obesity may be associated with better outcomes among patients on dialysis, many centres have been reluctant to transplant obese patients because of concerns over adverse outcomes in the short and long term. In this review, we evaluate data about the safety of weight loss on dialysis and critically review the impact of pre-transplant body mass index and sarcopenia on post-transplant outcomes. We also highlight comparative data on outcomes of obese patients on dialysis versus those undergoing kidney transplantation. We conclude that while obesity can increase the risk of complications such as wound infections or delayed graft function, selected obese patients can achieve good outcomes after transplantation with the risk being broadly comparable to other recipient co-morbidities such as diabetes mellitus.