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The editorial highlights obesity as a contributor to worse long-term results, with children experiencing more frequent and more severe postoperative complications after transplantation. Evidence also suggests compromised renal graft survival in obese pediatric recipients, supporting the need for an in-depth literature review.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/obesity-and-pediatric-renal-transplant-an-unholy-alliance/406722/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/obesity-and-pediatric-renal-transplant-an-unholy-alliance/406722.png","ImageObject",300,407,{"name":92,"@type":93},"Aldword","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is obesity a concern in pediatric renal transplantation?","Question",{"text":112,"@type":113},"Obesity is linked to poorer long-term outcomes and is associated with higher rates of postoperative complications in pediatric transplant recipients.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What evidence is discussed regarding graft survival?",{"text":117,"@type":113},"Reports indicate renal graft survival may be compromised in children with obesity, motivating an overview of available literature.",{"name":119,"@type":110,"acceptedAnswer":120},"What biological mechanisms are proposed to explain the relationship?",{"text":121,"@type":113},"The editorial describes inflammatory signaling, altered immune cell composition, gut microbiota and barrier disruption, insulin resistance, and effects of adipose-derived factors that may contribute to renal damage and graft failure.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},406722,1790763057,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","| W | J | N | World Journal of\u003Cbr>Nephrology |\n| --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Nephrol 2025 December 25; 14(4): 106428  \nDOI: 10.5527/wjn.v14.i4.106428 ISSN 2220-6124 (online)  \nEDITORIAL  \nObesity and pediatric renal transplant: An unholy alliance  \nKrishna Kumar Govindarajan  \nSpecialty type: Urology and nephrology  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade B, Grade B, Grade D  \nNovelty: Grade B, Grade B, Grade D  \nCreativity or Innovation: Grade B, Grade B, Grade D  \nScientific Significance: Grade A, Grade B, Grade C  \nP-Reviewer: Chen YH; Mayir B; Seshadri PR  \nReceived: February 26, 2025  \nRevised: April 6, 2025  \nAccepted: April 21, 2025  \nPublished online: December 25, 2025  \nProcessing time: 300 Days and 16.8 Hours  \nKrishna Kumar Govindarajan, Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India  \nCorresponding author: Krishna Kumar Govindarajan, MD, Professor, Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER Campus Road, Dhanvantari Nagar, Puducherry 605006, [India.](India. kkpeds@gmail.com)[ kkpeds@gmail.com](India. kkpeds@gmail.com)  \nAbstract  \nThe number of children requiring renal transplants is on the rise, increasing the need for the availability of donor kidneys. It is a challenge to match the need and the available pool. Hence, a renal transplant recipient undergoes rigorous scrutiny to ensure the best possible outcome. In this context, children with obesity harm the long-term outcome when they receive renal transplantation due to higher and more severe postoperative complications. In addition, reports indicate that renal graft survival appears to be compromised in recipient children who are obese. An in-depth review of the available evidence from the literature is required for better understanding.  \nKey Words: Obesity; Renal transplantation; Chronic kidney disease; Graft survival; Child; Body mass index  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \nCore Tip: Currently, there is an increase in the number of renal transplants in children globally. Due to the increasing need for renal grafts, there is a mismatch between the donor and recipient. To add to this problem, there is the problem of increased morbidity of renal transplantation in obese children, which is reviewed critically in this editorial.  \nCitation: Govindarajan KK. Obesity and pediatric renal transplant: An unholy alliance. World JNephrol 2025; 14(4): 106428  \nURL: [https://www.wjgnet.com/2220-6124/full/v14/i4/106428.htm](https://www.wjgnet.com/2220-6124/full/v14/i4/106428.htm)  \nDOI: [https://dx.doi.org/10.5527/wjn.v14.i4.106428](https://dx.doi.org/10.5527/wjn.v14.i4.106428)  \nIn children with chronic kidney disease (CKD), several risk factors, including hy-  \n WJN  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 25, 2025  Volume 14  Issue 4   \nGovindarajan KK. Obesity and pediatric renal transplant  \npertension, glomerular filtration rate, and proteinuria, are known to cause progression to renal failure. The rates of incidence of renal failure in children differ among the countries worldwide. Long-term outcomes after renal transplantation in children are important as growth and development are essential in achieving standard quality of life in adulthood. In this context, the survival of the child and the graft form the prime focus of the pediatric renal transplantation program. Issues relating to graft failure include adolescence, deceased donor transplantation, and focal segmental glomerulosclerosis as some of the common elements [1] . In addition, other less documented aspects, such as body weight, may have a significant impact. Limited data","cbCaipBW8EnPiAW1","https://ap.wps.com/l/cbCaipBW8EnPiAW1","pdf",346903,"English","# Abstract\n# Core Tip\n# Pathological Basis\n# The Evidence","[{\"question\":\"Why is obesity a concern in pediatric renal transplantation?\",\"answer\":\"Obesity is linked to poorer long-term outcomes and is associated with higher rates of postoperative complications in pediatric transplant recipients.\"},{\"question\":\"What evidence is discussed regarding graft survival?\",\"answer\":\"Reports indicate renal graft survival may be compromised in children with obesity, motivating an overview of available literature.\"},{\"question\":\"What biological mechanisms are proposed to explain the relationship?\",\"answer\":\"The editorial describes inflammatory signaling, altered immune cell composition, gut microbiota and barrier disruption, insulin resistance, and effects of adipose-derived factors that may contribute to renal damage and graft failure.\"}]","Obesity and pediatric renal transplant - An unholy alliance | PDF",1790567532]