Obesity is a recognized risk factor for type-2 diabetes mellitus (DM) and cardiovascular diseases and a risk factor in renal transplantation (Tx). Studies that have evaluated the effect of obesity on renal transplantation outcome have yielded varying results. This study explores the effect of BMI on the outcome of kidney transplantation at our centre. The records of 200 consecutive kidney recipients, transplanted since January 2004, were reviewed for the effect of BMI on: (1) the incidence of pre-Tx DM and ischaemic heart disease (IHD), (2) mean duration of Tx surgery (minutes) (3) mean hospital stay (days), (4) incidence of acute rejection (AR), (5) incidence of post-Tx surgical complications (SC) and systemic infection (SI), and (6) recipient and graft survival. Recipients were distributed in 4 groups according to BMI: [A] 25 under weight recipients (BMI<20), [B] 62 normal weight recipients (BMI 20-25), [C] 58 preobese recipients (BMI 25-30), and [D] 55 obese recipients (BMI>30). 56.5% of recipients were either obese (27.5%) or preobese (29%). Recipient mean age and donor source were comparable in all groups, and female recipients were more common in group D (73%).

Group	No.	Pre-Tx (%)		Duration surgery	Hosp stay	AR (%)	SC (%)	SI (%)	Recipient Survival	Graft Survival
		DM	IHD
A B C D	25 62 58 55	16 18 38 40	8 15 19 22	204 206 213 222	16 17 19 20	20 13 10 20	32 34 40 65	56 48 55 64	96 94 93 85	96 92 86 80

The majority of recipients were either pre-obese or obese. Kidney recipients with higher BMI were observed to have: increased rates of pre-Tx DM and IHD, longer duration of Tx surgery, longer hospital stay, and suffered of higher rates of surgical complications. Recipients of normal BMI showed lower rates of acute rejection and systemic infections. Increasing BMI was associated with lower recipient and graft survival rates.