Prevalence of Obesity, Comorbidities, and Eligibility for Pre-Transplant Bariatric Surgery in 275 Patients Awaiting Kidney Transplant at a Single Center in Germany

Background:Obesity contributes to chronic kidney disease (CKD) through various mechanisms and increase morbidity and mortality after kidney transplantation.Bariatric surgery can reduce perioperative risks.This study aimed to determine the prevalence of obesity in kidney transplant candidates, associations with demographic and clinical factors, and to estimate the proportion of patients potentially eligible for bariatric surgery in a German cohort. Material/Methods:This retrospective single-center study included 275 patients listed for kidney transplantation between November 2018 and January 2020 at the University Hospital Frankfurt.Prevalence analyses were limited to 271 patients.Variables included body mass index (BMI), comorbidities, cause of kidney disease, dialysis duration, transplant list status, and prior bariatric surgery.The primary endpoint was the prevalence of obesity; secondary endpoints were correlations between obesity and comorbidities.Statistical analyses included Spearman's correlation and Eta coefficient analyses to evaluate associations.Prevalence estimates are reported with 95% confidence intervals. Results:The mean BMI was 25.8 kg/m 2 .BMI correlated with arterial hypertension (h=0.121;P=0.047) and diabetes mellitus (h=0.305;P<0.001), while no significant correlation was observed with transplant list status (h=0.051;P=0.704).Among the 56 obese patients, 6 (10.7%) had BMI 35-39.9kg/m 2 and 4 (7.1%) had BMI 40 kg/m 2 , meeting common eligibility criteria for bariatric surgery.The prevalence of obesity was 20.7% (95% CI, 1.16-1.25). Conclusions:Obesity is prevalent in this population.Given that obesity is a modifiable risk factor, identifying candidates who may benefit from weight-management interventions is clinically relevant; however, this prevalence study does not allow conclusions regarding outcomes or treatment efficacy.