Transplant Outcomes and Weight Management in Renal Disease Study

This study aims to assess the impact of weight gain on patient and graft survival in renal transplant recipients over a 10-year period.

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.

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.

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.