The DOI matches its Crossref record; 103 of the 103 references it cites were found in a registry or an index.
Body mass index and outcome in renal transplant recipients: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Whether overweight or obese end stage renal disease (ESRD) patients are suitable for renal transplantation (RT) is often debated. The objective of this review and meta-analysis was to systematically investigate the outcome of low versus high BMI recipients after RT. METHODS: Comprehensive searches were conducted in MEDLINE OvidSP, Web of Science, Google Scholar, Embase, and CENTRAL (the Cochrane Library 2014, issue 8). We reviewed four major guidelines that are available regarding (potential) RT recipients. The methodology was in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and written based on the PRISMA statement. The quality assessment of studies was performed by using the GRADE tool. A meta-analysis was performed using Review Manager 5.3. Random-effects models were used. RESULTS: After identifying 5,526 studies addressing this topic, 56 studies were included. We extracted data for 37 outcome measures (including data of more than 209,000 RT recipients), of which 26 could be meta-analysed. The following outcome measures demonstrated significant differences in favour of low BMI (<30) recipients: mortality (RR = 1.52), delayed graft function (RR = 1.52), acute rejection (RR = 1.17), 1-, 2-, and 3-year graft survival (RR = 0.97, 0.95, and 0.97), 1-, 2-, and 3-year patient survival (RR = 0.99, 0.99, and 0.99), wound infection and dehiscence (RR = 3.13 and 4.85), NODAT (RR = 2.24), length of hospital stay (2.31 days), operation duration (0.77 hours), hypertension (RR = 1.35), and incisional hernia (RR = 2.72). However, patient survival expressed in hazard ratios was in significant favour of high BMI recipients. Differences in other outcome parameters were not significant. CONCLUSIONS: Several of the pooled outcome measurements show significant benefits for 'low' BMI (<30) recipients. Therefore, we postulate that ESRD patients with a BMI >30 preferably should lose weight prior to RT. If this cannot be achieved with common measures, in morbidly obese RT candidates, bariatric surgery could be considered.
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“Overweight and obesity after KTx are strongly associated with adverse outcomes.”
From Cognitive-behavioral and dietary weight loss intervention in adult kidney transplant recipients with overweight and obesity: Results of a pilot RCT study (Adi-KTx) (2023) · cites this paper as [12]
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“They reported higher rates of complications early after transplantation, including delayed graft functioning and surgical complications as well as a higher rate of adverse long-term complications such as cardiovascular diseases.”
From Cognitive-behavioral and dietary weight loss intervention in adult kidney transplant recipients with overweight and obesity: Results of a pilot RCT study (Adi-KTx) (2023) · cites this paper as [12]
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“Regarding the association between obesity and graft loss as well as morbidity, the findings are controversial (6, 10–13).”
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“Additionally, an association between overweight and the development of new-onset diabetes after transplantation (NODAT) and hypertension has been described (12).”
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Citations
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
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Bariatric Surgery: A Systematic Review and Meta-analysis
Buchwald, H., Avidor, Y., Braunwald, E., Jensen, M. D., Pories, W., Fahrbach, K., & Schoelles, K. (2004) · JAMA · doi:10.1001/jama.292.14.1724 · Cited by 6,800
Special Issue: KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients
Eckardt, K., Kasiske, B. L., & Zeier, M. G. (2009) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2009.02834.x · Cited by 1,574
Meta-Analysis: Surgical Treatment of Obesity
Maggard, M. A., Shugarman, L. R., Suttorp, M. J., Maglione, M., Sugerman, H. J., Livingston, E. H., Nguyen, N. T., Li, Z., Mojica, W., Hilton, L. G., et al. (2005) · Annals of Internal Medicine · doi:10.7326/0003-4819-142-7-200504050-00013 · Cited by 1,567
Perioperative safety in the longitudinal assessment of bariatric surgery
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American Heart Association Call to Action: Obesity as a Major Risk Factor for Coronary Heart Disease
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Association between obesity and kidney disease: A systematic review and meta-analysis
Wang, Y., Chen, X., Song, Y., Caballero, B. H., & Cheskin, L. J. (2007) · Kidney International · doi:10.1038/sj.ki.5002586 · Cited by 693
Research works printed but not linked: 12
- Turner C, Nogueira J. The effect of obesity on allograft outcomes in a single-center cohort of living renal transplant recipients. Am J Transplant. 2007;7:464.
- Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. 2011.
- Begov I, Akkina S, Benedetti E, Tang I. Obesity does not adversely affect the outcomes of kidney transplantation. Am J Transplant. 2013;13:261.
- Farooq U, Alshraideh Y, Orlando G, Rogers J, Farney A, Stratta R. Does high recipient BMI influence outcomes in deceased donor kidney transplantation? A paired donor kidney analysis. Am J Transplant. 2014;14:74.
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- Impedovo SV, Palazzo S, Bettocchi C, Grandaliano G, Schena FP, Gesualdo L, et al. Effect of obesity on long-term results of renal transplantation: a single center experience. Am J Transplant. 2012;12:249.
- Powers BD, Sifontis NM, Yung E, Spurrier D, Constantinescu S, Lee I, et al. 3 year outcomes of renal transplantation in high-risk obese recipients. Am J Transplant. 2010;10:64.
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- Ravindra K, Irish W, Vikraman D, Castleberry A, Barbas A, Sanoff S, et al. Impact of recipient BMI: implications for ECD renal transplantation. Am J Transplant. 2013;13:195.
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Cited by
Sorted by citations
De Luca, M., Angrisani, L., Himpens, J., Busetto, L., Scopinaro, N., Weiner, R., Sartori, A., Stier, C., Lakdawala, M., Bhasker, A. G., et al. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2271-4 · Cited by 296
“Outcome measures of more than 209,000 renal transplant recipients demonstrated significant differences in favor of factors such as lower BMI (<30 kg/ m(2)); lower mortality; delayed graft function; acute rejection; 1-, 2-, and 3-year graft survival; 1-, 2-, and 3-year patient survival; wound infection and dehiscence;…”
BackgroundClinical practice guideline exercise and lifestyle in chronic kidney disease
Baker, L. A., March, D. S., Wilkinson, T. J., Billany, R. E., BISHOP, N. C., Castle, E. M., Chilcot, J., Davies, M. D., Graham-Brown, M. P. M., Greenwood, S. A., et al. (2022) · BMC Nephrology · doi:10.1186/s12882-021-02618-1 · Cited by 289
Ladhani, M., Craig, J. C., Irving, M. J., Clayton, P. A., & Wong, G. (2016) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfw075 · Cited by 187
“|| || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || || advantage at 1, 2 and 3 years after transplantation compared…”
Lafranca, J. A., IJzermans, J. N. M., Betjes, M. G. H., & Dor, F. J. M. F. (2015) · BMC Medicine · doi:10.1186/s12916-015-0387-3 · Cited by 115
“Erratum Authors’ corrected note: Jan NM IJzermans last name was incorrectly spelled in the author list and was indicated as Jan NM IJermans in our published article [1].”
BackgroundObesity Paradox in Advanced Kidney Disease: From Bedside to the Bench
Naderi, N., Kleine, C., Park, C., Hsiung, J., Soohoo, M., Tantisattamo, E., Streja, E., Kalantar‐Zadeh, K., & Moradi, H. (2018) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2018.07.001 · Cited by 113
Metadata
- Authors
- Lafranca, J. A., IJermans, J. N., Betjes, M. G., & Dor, F. J.
- Affiliations
- Erasmus MC (NL)
- Corresponding author
- Dor, Frank JMF
- Venue
- BMC Medicine
- Published
- 2015-05-12
- Volume
- 13
- Issue
- 1
- Pages
- 111-111
- ISSN
- 1741-7015 (ISSN-L)
- PMC
- PMC4427990
- OpenAlex
- W4211251578
- Cited by
- 222
- References
- 103
- Citations by year
- 2026: 20 · 2025: 15 · 2024: 15 · 2023: 26 · 2022: 31 · 2021: 34 · 2020: 14 · 2019: 22 · 2018: 13 · 2017: 18 · 2016: 9 · 2015: 2
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Update notices
- erratum (2015-06-15)
- Open access
- gold
- doi.org
- Locations
- BMC Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Organ Donation and Transplantation
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Keywords
- body mass index, kidney transplantation, obesity, end-stage renal disease, transplant outcomes, graft survival, mortality, delayed graft function, acute rejection, wound infection, bariatric surgery, weight loss, morbid obesity
- MeSH terms
- Female, Humans, Obesity, Morbid, Body Mass Index, Kidney Transplantation, Treatment Outcome, Transplant Recipients
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