High prevalence of obesity in Thai renal transplant recipients: A multicenter study

Background Obesity is a risk factor for cardiovascular disease and cardiovascular mortality in renal transplant recipients (RTRs). There are limited studies of prevalence and associated factors of obesity in Asian RTRs. Methods A cross-sectional study was conducted from July to December 2012 in 4 kidney transplant centers in Bangkok, Thailand. Obesity was diagnosed based on the International Obesity Taskforce-proposed classification. At risk of obesity, obese I, and obese II were defined as having a body mass index (BMI) of 23-24.9 kg/m², 25-29.9 kg/m², and ≥30 kg/m², respectively. Results Of 263 recipients studied, 50 (19.0%), 70 (26.6%), and 17 (6.5%) were at risk of obesity, obese I, and obese II, respectively. The prevalence of obesity was 12.6% in the 1st year, was 28.6% in the first 3 years, and rose to 39.7% after 3 years after transplantation. Age (odds ratio [OR], 1.04; 95% CI, 1.01-1.07), systolic blood pressure ≥130/85 mm Hg (OR, 2.82; 95% CI, 1.51-5.26), number of antihypertensive medications (OR, 1.99; 95% CI, 1.42-2.79), fasting plasma glucose (OR, 1.03; 95% CI, 1.01-1.04,) and high-density lipoprotein (HDL) cholesterol (OR, 0.96; 95% CI, 0.94-0.98) were associated with obesity. Compared with 100 RTRs with normal BMI, obese patients tended to have higher prevalence of chronic kidney disease (OR, 1.59; 95% CI, 0.89-2.83). Conclusions The study demonstrates the high prevalence of obesity in Thai RTRs especially after 3 years after transplantation. Obesity is more prevalent with advanced age and variable components of metabolic syndrome in the RTR population. Obese RTRs had significantly higher blood pressure and required more antihypertensive medication when compared with RTRs with normal BMI.