Objective: This retrospective cohort study aimed to investigate the association between BMI changes post-renal transplantation and clinical outcomes, including changes in hemoglobin A1c (HbA1c), creatinine, estimated glomerular filtration rate, blood pressure, and graft rejection.
Methods: A total of 629 adult kidney transplant recipients were analyzed between January 2016 and January 2024 at King Abdulaziz Medical City under the Ministry of National Guard Health Affairs in Saudi Arabia, Riyadh. Baseline demographics, BMI measurements (recorded at baseline and 1-, 6-, 12-, and 24-month post-trans plant, and clinical outcomes (patient survival, graft survival, and complications) were collected through a comprehensive chart review.
Results: Significant weight gain was observed (median BMI increase: 26.1-28.7 kg/m², p < 0.001), particularly in patients with baseline BMI < 30 (p-value < 0.001). Weight changes did not significantly impact graft rejection or mortality. However, weight loss was associated with improved glycemic control overall (p-value = 0.020) and in people with diabetes (p-value = 0.011). Systolic blood pressure decreased post-transplant (p-value < 0.05), with a more significant reduction in the BMI < 30 group (p-value = 0.023).
Conclusion: There was a tendency toward weight gain after kidney transplantation, especially in patients with lower baseline BMI. At 24 months following transplantation, patients with less than 30 BMI had a more significant reduction in systolic blood pressure compared to people with higher BMI. Worsening glycemic control was noticed regardless of BMI change.
Key words: BMI changes, renal transplantation, clinical outcomes, diabetes mellitus, systolic blood pressure, graft rejection
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