Influence of Body Mass on Kidney Graft Function in Patients After Kidney Transplantation.

BACKGROUND: Increasing evidence shows that body mass may play a role in complications after kidney transplantation and influence graft and patient survival. The aim of this study was to analyze the association between graft function and both the body mass and adipokines (leptin, visfatin, adiponectin) in kidney transplant recipients. METHODS: We studied 183 kidney transplant recipients from the Department of Nephrology, Transplantology and Internal Disease, Medical University of Gdansk. Anthropometry and body composition examinations were performed using an electronic scale, hand grip dynamometer, and BCM - Body Composition Monitor (Fresenius, Germany). Obesity, overweight, and underweight were defined according to body mass index (BMI) classification. Blood urea nitrogen, creatinine, blood morphology, lipidogram, albumin, and C-reactive protein were measured. Estimated glomerular filtration rate (eGFR) was calculated according to the Chronic Kidney Disease Epidemiology Collaboration formula. Leptin, visfatin, and adiponectin were measured by ELISA methods. RESULTS: Underweight was found in 16 (8.7%) KTR, overweight and obesity were observed in 68 (37.1%) and 26 (14.2%) patients, respectively. No relation between BMI and eGFR in all groups was noted, but in the early period after transplantation a correlation between BMI and creatinine and eGFR was observed. In all studied patients (also patients in the early posttransplantation period), eGFR significantly correlated with leptin and visfatin. Multiple regression analysis confirmed an association between eGFR and leptin and visfatin in all studied populations and between eGFR and BMI in the group examined shortly after transplantation. CONCLUSIONS: Sarcopenic overweight and obesity prevail in KTR. In the short-term but not long-term period after transplantation, worse graft function was associated with high BMI. An association between graft function and leptin and visfatin was noted.