Cited by 103Renal Transplantation Outcomes and TreatmentsDialysis and Renal Disease ManagementObesity, Physical Activity, Diet

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Body Mass Index and Mortality in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

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Ahmadi, Seyed-Foad, Zahmatkesh, Golara, Streja, Elani, Molnar, Miklos Z., Rhee, Connie M., Kovesdy, Csaba P., Gillen, Daniel L., Steiner, Shah, Kalantar-Zadeh, Kamyar·2014·American Journal of Nephrology

DOI 10.1159/000367812PMC PMC4319181

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Abstract

BACKGROUND: A higher body mass index (BMI) seems to be linked to survival advantage in maintenance hemodialysis patients. However, it is uncertain if this 'obesity survival paradox' is also observed in kidney transplant recipients. Hence, we systematically reviewed the literature on the impact of pre-transplantation BMI on all-cause mortality in this population. METHODS: We searched MEDLINE, EMBASE, Web of Science, CINAHL, and Cochrane CENTRAL for relevant studies up to July 2013. Two investigators independently selected the studies using predefined criteria, abstracted the data from the included studies, and independently assessed each study's quality using the Newcastle-Ottawa Quality Assessment Scale. In addition to the qualitative synthesis, we quantitatively pooled the results of the studies with clinical, methodological, and statistical homogeneity. RESULTS: We screened 7,123 records, from which we included 11 studies (with a total of 305,392 participants) in this systematic review and 4 studies in the meta-analyses. In the only study that included children, obesity was linked to higher mortality in children of 6-12 years old. For adults, our meta-analyses indicated that compared to normal BMI, underweight [Hazard Ratio (HR): 1.09; 95% Confidence Interval (CI): 1.02-1.20], overweight (HR: 1.07; 95% CI: 1.04-1.12), and obese (HR: 1.20; 95% CI: 1.14-1.23) levels of BMI were associated with higher mortality. CONCLUSION: The presence of the obesity survival paradox is unlikely in kidney transplant recipients since both extremes of pre-transplantation BMI are linked to higher mortality in this population.

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ACUTE GENERAL PERITONITIS.
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Authors: Ahmadi, S.-F., Zahmatkesh, G., Streja, E., Molnar, M. Z., Rhee, C. M., Kovesdy, C. P., Gillen, D. L., Steiner, S., & Kalantar-Zadeh, K.
Affiliations: University of California, Irvine Medical Center (US)
University of Tennessee Health Science Center (US)
Memphis VA Medical Center (US)
University of California, Irvine (US)
ORCID: Streja, Elani
Molnar, Miklos Z.
Rhee, Connie M.
Kovesdy, Csaba P.
Gillen, Daniel L.
Kalantar-Zadeh, Kamyar
Venue: American Journal of Nephrology
Publisher: S. Karger AG
Published: 2014
Volume: 40
Issue: 4
Pages: 315-324
ISSN: 0250-8095 (ISSN-L)
1421-9670
DOI: 10.1159/000367812
PMC: PMC4319181
OpenAlex: W2083852602
Cited by: 103
References: 22
Citations by year: 2026: 6 · 2025: 7 · 2024: 6 · 2023: 7 · 2022: 9 · 2021: 13 · 2020: 6 · 2019: 7 · 2018: 11 · 2017: 9 · 2016: 8 · 2015: 13
FWCI: 1.81
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.karger.com/Services/SiteLicenses (vor)
www.karger.com/Services/SiteLicenses (tdm)
Locations: American Journal of Nephrology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders: National Institutes of Health
National Institute on Aging (R21AG047036)
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK078106, R13DK094686, R01DK096920, R01DK095668, K24DK091419)
Topics: Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords: body mass index, kidney transplant recipients, all-cause mortality, underweight, overweight, obesity, children, hemodialysis
MeSH terms: Adult, Child, Graft Survival, Humans, Body Mass Index, Kidney Transplantation

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Body Mass Index and Mortality in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

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