Introduction: Weight gain after transplantation is common and related to increased appetite with reversal of uremia, steroid use in the post-transplant period and relative physical inactivity. High body mass index correlates with diabetes, high blood pressure and plasma lipids as well as proteinuria and graft dysfunction. Patients with over weight and obesity tent to be older, diabetic and more likely to have had delayed graft function.
Aim: Overweight and obesity are very common in post renal transplant recipient in India . We looked at this issue by using conventional wearable BCM ,DEXA and BMI.
Methods: We did a retrospective study of 249 post-transplant patients who successfully underwent renal transplantation over a period of 10 years at a tertiary care center in south-India. Written consent was obtained from all the patients. Assessment of overweight and obesity was done using DEXA and BMI. The wearable BCM also used in the study to find out the fat store of the patients. Patient’s demographics such as age, sex, and a proxy of indicators of nutritional status were used: Serum assays such as S. albumin, hemoglobin (hb%), High-Density- Lipoprotein (HDL), Low-Density-Lipoprotein (LDL), Triglycerides (TGl), Serum Calcium, Inorganic Phosphate, and electrolytes: sodium, potassium, chloride, bicarbonate, and renal parameters: serum creatinine were obtained from the blood investigation reports; lifestyle factors, body mass index, the presence of DM were obtained from hospital records and oral questionnaires. We considered the first month (baseline) and the 6th month reports, in this study. All transplant recipients underwent a SEXA scan done  to evaluate body composition, including Lean Body Mass (LBM), Fat Mass(FM) and Fat Percentage(Fat%). 
Results: Among the 249 selected patients 150 were male and 99 female and their mean age was 45.98 years. Fifty six percentage of the patients were diabetes and 76% were nonvegetarians. There was a marked increase in the LDL (baseline mean =90.85mg/dl , follow up mean =121.4 mg/dl) , TGL (baseline mean =113.7 mg/dl , follow up =121.4 mg/dl) cholestrol level from the baseline to the follow up (baseline mean =90.85mg/dl , follow up =160 mg/dl). While assessing the BMI the overweight(18.5 – 22.9 kg/m²) percentage increased from 21% to24.8 %, Obese class I( 23-24.9 kg/m²) from 5% to 18.9 %, Obese II ( ≥ 30 kg/m²)- from 2.4% to 4.8% . Similarly the DEXA scan results showed increase in Body fat Mass: baseline -19.48±9 kgs, follow up -23.9± 10 kgs.
Conclusion: We found increase in BMI ,Lipid status, body fat mass increases following KTR. This calls for stricts nutritional advice and lifestyle adjustment and medical therapy as coronary artery disease and other comorbidities can be successfully manged.