Post-Kidney Transplant Adverse Outcomes Increased With BMI-BSA Obesity

Risks were significantly greater than when body mass index and body surface area were discordant

By Elana Gotkine HealthDay Reporter

TUESDAY, May 27, 2025 (HealthDay News) — Combined body mass index (BMI)-body surface area (BSA) obesity is associated with an increased risk for post-kidney transplant (KT) adverse outcomes, according to a study published online May 21 in Transplantation Direct.

Roxaneh Zaminpeyma, from Dalhousie University in Halifax, Nova Scotia, Canada, and colleagues examined post-KT adverse outcomes associated with obesity, defined using combined BMI-BSA parameters, in a cohort of adult KT recipients across the United States.

A total of 242,432 patients were included in the final study: 32.0 and 28.6 percent had obesity based on BMI and BSA, respectively. The researchers found that the adjusted risk for death-censored graft loss, all-cause graft loss, and delayed graft function was greatest when both BMI and BSA indicated obesity compared with nonobese BMI and BSA (adjusted hazard ratios, 1.23, 1.09, and 1.58, respectively); the risk was significantly greater than when BMI and BSA were discordant.

“Patients with discordance between obesity-defined BMI and BSA are at significantly lower risk than those categorized as obese by both BMI and BSA metrics,” the authors write. “Combined BMI-BSA-defined obesity should be considered when defining obesity-related risk at the time of kidney transplantation.”

Several authors disclosed ties to the biopharmaceutical industry.

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