Body Mass Index Impact on the Long-Term Outcome after Kidney Transplantation in Japanese Patients


Body Mass Index Impact on the Long-Term Outcome after Kidney Transplantation in Japanese Patients

The obesity adversely affects the condition of a patient with AKI and CKD. On the other hand, it is a fact that BMI relates to the survival rate positively in the patients on dialysis, since a drop of the muscle quantity drives malnutrition as the cause of poor patients survival. When such an end-stage renal disease (ESRD) patient is going to receive a renal transplantation, weight loss is instructed in many institutes because of a consideration for complications after the transplant. It has not been well answered whether or not and how much we have to improve obesity before renal transplantation for an altitude obesity patient. In order to prevent complications after transplant, it is necessary to lose weight without reducing quantity of muscle.

Obesity control guideline in Japan (2006) recommended that overweight case should diet intake restriction (25 kcal/kg/day) along with standard body weight. But well-controlled CKD patients have been restricted in protein intake (0.6 g/kg/day). Calorie restriction in CKD patients may result in mal-nutrition and Nitrate unbalance with simple weight loss for BMI control. Pretransplant high BMI and high muscle volume was reported not to be surgical and immunological risk because of low mortality and graft failure ratio. We have to adjust each recipient’s nutrition status (serum albumin, protein intake) in order to prevent the trap of ‘obesity paradox’

We must pay much attention for low   with high BMI patient as a true high risk recipient (sarcopenia obesity) which is independent risk factor of post-transplant morbidity and mortality. For the future, we will test the body cell mass analysis for CVD, fat obesity risk criteria using impedance evaluation other than BMI. Our data was small in patient number and there are some limitations existed in our study. Overweight patient population was different from other western countries, our retrospective cohort study could not reveal the significance of BMI in outcome of kidney transplantation and background patient cohort of our data was different among the 4 groups in some clinical patient’s characters.


Overweight (BMI>25.0) in Japanese kidney recipients might affect post-transplant infectious disease occurrence; however, it is not a deteriorating factor for long-term allograft survival.

Journal of Nephrology and Urology is an Open Access peer-reviewed publication that discusses current research and advancements in diagnosis and management of kidney disorders as well as related epidemiology, pathophysiology and molecular genetics.

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Journal of Nephrology and Urology