Incidence and Risk Factors of Obesity and Overweight in Kidney Transplant Recipients and Their Effect on Graft...

Weight gain is common after kidney transplantation. This study assessed the incidence of overweight and obesity, identified the risk factors, and evaluated their impact on graft function and metabolic outcomes at 1 year.

This retrospective observational study included 179 kidney transplant recipients at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia, between January 2020 and December 2023. The baseline and 12-month BMI were recorded. Associations with demographic, clinical, and metabolic variables, as well as graft function and complications, were analyzed. Logistic regression identified independent predictors of being overweight (BMI ≥ 25 kg/m²) and obese (BMI ≥ 30 kg/m²).

At baseline, 83 (46.4%) recipients had BMI < 25 kg/m², 55 (30.7%) were overweight, and 41 (22.9%) were obese. At 12 months, the prevalence of obesity increased to 67 (37.4%), while the normal BMI category decreased to 55 (30.7%), with the overweight category remaining relatively stable at 57 (31.8%). The baseline BMI was the strongest predictor of overweight (OR 1.72, 95% CI 1.45-2.04) and obesity (OR 1.74, 95% CI 1.47-2.05) at 12 months. In sensitivity analysis excluding the baseline BMI, a family history of diabetes predicted obesity (OR 4.41, 95% CI 1.78-10.96). Obese patients had numerically higher creatinine and lower eGFR, but differences were not statistically significant. No differences were observed in CMV infection, prediabetes, new-onset diabetes after transplantation, acute coronary syndrome, or mortality. Overall, patient survival was 100% at 12 months.

Posttransplant overweight and obesity are common. The baseline BMI and family history of diabetes are key predictors. The higher BMI is associated with early metabolic changes and trends toward lower graft function, highlighting the need for early monitoring and targeted interventions.