Transplant Outcomes and Weight Management in Renal Disease Study.

Aim: This study aims to assess the impact of weight gain on patient and graft survival in renal transplant recipients over a 10-year period. Materials and Methods: A retrospective cohort study was conducted on 716 renal transplant recipients aged 18-67 at a tertiary care center in South India. Weight change was assessed at 1 year and at the last follow-up, with significant weight gain defined as an increase of more than 5%. Data on baseline characteristics, comorbidities, and transplant-related factors were collected. Statistical analyses, including Log Rank and Mantel-Cox tests, were used to evaluate the impact of weight gain on survival outcomes, while logistic regression identified factors influencing weight gain and loss. Results: At 1-year posttransplant, 70% of patients experienced weight gain, with 54.1% showing significant increases. Significant weight gain at 1 year was not associated with improved patient survival. However, at the last follow-up, 79.3% of patients had gained weight, with 68.7% showing significant increases. Significant weight gain at the last follow-up was associated with improved graft and patient survival. Factors influencing weight gain included age at transplant (odds ratio [OR] =1.05), female gender (OR = 1.40), and cytomegalovirus (CMV) viremia (OR = 1.25). Factors influencing weight loss included age (OR = 1.07), pretransplant hypertension (OR = 1.50), posttransplant hypertension (OR = 1.45), and CMV viremia (OR = 1.30). However, excessive weight gain culminating in Class II obesity was associated with reduced patient survival. Conclusion: Significant weight gain after renal transplantation is common and linked to improved graft and patient survival at the last follow-up. These findings emphasize the need for monitoring weight posttransplant and implementing targeted interventions to manage weight gain, potentially enhancing long-term outcomes for transplant recipients.