One year posttransplant BMI and BMI increment are more strongly related to death and graft failure than pretransplant BMI among kidney transplant recipients. Patients with BMI more than 30 kg/m compared with a normal BMI have approximately 20% to 40% higher risk for death and graft failure.

Summary To determine short‐ and long‐term patient and graft survival in obese [body mass index (BMI) ≥ 30 kg/m2] and nonobese (BMI < 30 kg/m2) renal transplant patients we retrospectively analyzed our national‐database. Patients 18 years or older receiving a primary transplant after 1993 were included. A total of 1871 patients were included in the nonobese group and 196 in the obese group. In the obese group there were significantly more females (52% vs. 38.6%, P < 0.01) and patients were significantly older [52 years (43–59) vs. 48 years (37–58); P < 0.05]. Patient survival and graft survival were significantly decreased in obese renal transplant recipients (1 and 5 year patient survival were respectively 94% vs. 97% and 81% vs. 89%, P < 0.01; 1 and 5 year graft survival were respectively 86% vs. 92% and 71% vs. 80%, P < 0.01). Initial BMI was an independent predictor for patient death and graft failure. This large retrospective study shows that both graft and patient survival are significantly lower in obese renal transplant recipients.

Summary The prevalence of cardiovascular risk factors in renal transplant candidates is high. A better understanding of the relation between these risk factors and cardiovascular morbidity and mortality is mandatory to improve transplantation outcome. In this retrospective cohort study 2187 adult patients who received a first kidney transplant between 1984 and 1997 were included. We analyzed the incidence of post‐transplant cardiovascular events and tried to identify independent pretransplant risk factors for post‐transplant cardiovascular events and all‐cause mortality. The cumulative incidence of post‐transplant cardiovascular events was 40%. The incidence was highest in the first 3 months after transplantation. Independent pretransplant risk factors for a post‐transplant cardiovascular event were diabetic nephropathy [Hazard ratio (HR) 3.02; 95% CI 2.85–3.98], claudication [HR 2.17 (1.42–3.31)], cardiac event [HR 1.76 (1.32–2.33)], cerebrovascular accident HR 1.53 (1.03–2.28), time‐on‐dialysis [HR 1.06 (1.02–1.11)], recipient age [HR 1.04 (1.04–1.05)], and body mass index [HR 1.03 (1.00–1.05)]. Diabetic nephropathy and cardiovascular disease were also important predictors for all‐cause mortality. Diabetic nephropathy and cardiovascular disease were the most important predictors for cardiovascular events and all‐cause mortality after renal transplantation. Early treatment of cardiovascular risk factors and pretransplant cardiovascular evaluation might improve transplantation outcome.

Pre-dialytic PC increased during the sodium profile, and did not differ between BV- or PC-controlled feedback compared to standard HD. Thus, it appears that both BV- and PC-controlled feedback can be safely prescribed without substantial salt- and water-loading, at least in the short term. Analysis of IMB is useful to assess differences in sodium balance between single treatment sessions but appears of less value in a steady-state situation.

The incidence of significant cardiac ischaemia in high-risk renal transplant patients was low and was followed by revascularization in a small percentage of patients. No significant decrease in perioperative cardiac events was observed after the introduction of the standardized cardiac assessment programme.