Weight gain after renal transplantation is a risk factor for patient and graft outcome

Background. The present study aimed to evaluate the effect of weight gain after transplantation on patient and graft outcome. Methods. Patients receiving kidney transplants between April 1986 and April 2001 were divided according to their body mass index (BMI) at 6 months after transplantation into group I, BMI less than 25 (normal weight); group II, BMI greater than or equal to 25 and less than 30 (overweight); and group III, BMI greater than or equal to 30 (obese) after exclusion of pediatric patients (aged ≤18 years), second transplant recipients, those with a history of cardiovascular disease, and those with a BMI less than 25 and greater than 18.5 kg/m2. Six hundred fifty kidney transplant recipients were selected for this retrospective study. Results. There was a statistically significant increase in the incidence of posttransplant hypertension, diabetes mellitus, and ischemic heart disease in the obese group. The incidence and frequency of acute rejection episodes were similar in the three groups. A trend toward decreased graft and patient survival, which reached significance at 5 years and 10 years, was observed in the obese group. Conclusions. BMI has a strong association with outcomes after renal transplantation independent of most of the known risk factors for patient and graft survival.