*Purpose: The obesity is increasing in chronic kidney disease patients and associated with poor renal outcome. The role of inflammation within the adipose tissue in obesity as a key factor in the pathogenesis of obesity-related complications. Such nonimmunological injuries as well as immunological injuries further accelerate worsen graft outcome in transplant recipients. The present study examined whether the high increased weight gain levels of post-transplantation at the first year is an important risk factor for long-term graft survival of kidney transplantation (KT) patients.

*Methods: We included 2699 adult recipients who underwent KT in single center with more than one-year follow-up period. Covariates in cox-regression model included dialysis duration before KT, recipient age and sex, related status, acute rejection status, diabetes, and weight gain at 1 year after KT. Participants were divided into two groups according to their weight gain tatus.

*Results: Graft survival rate estimated by Kaplan-Meier estimator was significantly lower in the participants who had eGFR more than 5kg weight gain in kidney recipient (log-rank test p<.001). The multivariable Cox regression adjusting covariates including recipient age and sex, related status, acute rejection status and diabetes status showed that the increased weight gain group has the significant association with higher graft failure (HR=1.278, p=0.027).

*Conclusions: Our data support that the increased weight gain at 1 year after KT is associated with poor outcome for long-term kidney graft survival in KT recipients.

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