FACTORS INFLUENCING WEIGHT-GAIN AFTER RENAL-TRANSPLANTATION

Weight gain following renal transplantation occurs frequently but has not been investigated quantitatively. A retrospective chart review of 115 adult renal transplant recipients was used to describe patterns of weight gain during the first 5 years after transplantation. Only 23 s ubjects (21%) were overweight before their transplant. Sixty-six subje cts (57%) experienced a weight gain of greater than or equal to 10%, a nd 49 subjects (43%) were overweight according to Metropolitan relativ e weight criteria at 1 year after transplantation. There was an invers e correlation between advancing age and weight gain, with the youngest patients (18-29 years) having a 13.3% weight gain and the oldest pati ents (age greater than 50 years) having the lowest gain of 8.3% at 1 y ear (P=0.047). Black recipients experienced a greater weight gain than whites during the first posttransplant year (14.6% vs. 9.0%; P=0.043) , and maintained or increased this difference over the 5-year period. Men and women experienced comparable weight gain during the first year (9.5% vs. 12.1%), but women continued to gain weight throughout the 5 -year study (21.0% total weight gain). The men remained stable after t he first year (10.8% total weight gain). Recipients who experienced at least a 10% weight gain also increased their serum cholesterol (mean 261 vs. 219) and triglyceride (mean 277 vs. 159) levels significantly, whereas those without weight gain did not. Weight gain did not correl ate with cumulative steroid dose, donor source (living-related versus cadaver), rejection history, pre-existing obesity, the number of month s on dialysis before transplantation, or posttransplant renal function . Posttransplant weight gain is related mainly to demographic factors, not to treatment factors associated with the transplant. The average weight gain during the first year after renal transplantation is appro ximately 10%. This increased weight, coupled with changes in lipid met abolism, may be significant in terms of altering risk from cardiovascu lar morbidity.