Body composition assessed by impedance changes very early with declining renal graft function.
BACKGROUND
Kidney transplant (Tx) restores renal filtration, although it does not achieve the function of two native kidneys, and with time it may variably involute back to chronic renal failure. We hypothesized that bioelectrical impedance analysis (BIA) might highlight differences for body compartments among Tx with different filtration rates, and we compared them with healthy controls.


METHODS
38 Tx patients (25 males, 13 females) were studied at 75.9 +/- 37.8 months postsurgery and divided into three groups: good creatinine clearance (CrCl, ml/min/1.73 m2; > 65.0), borderline (35.0 < CrCl < 60.0) and bad (CrCl < 35.0). BIA was assessed three times in a year. Total body water, extracellular water (ECW), intracellular water (ICW), Na:K exchange rate (Nae:Ke) and phase angle were studied. Healthy (n = 11) and hemodialysis (n = 11) groups were also studied.


RESULTS
BIA showed no differences between healthy controls and good Tx while both borderline and bad Tx presented a significantly higher ECW and lower ICW than either good Tx or normal controls. Only good CrCl was different from predialysis.


CONCLUSIONS
A good kidney graft manages to restore and maintain normal body composition, even with potential disturbances brought about by steroids and cyclosporine. With mild renal dysfunction a change in body compartments was observed, moving towards the composition of that with chronic renal failure patients.
Coroas
Andreia S P S
AS
Faculty of Nutrition and Food Sciences, S. João Hospital, Porto, Portugal. jcasimiro@mail.telepac.pt
Oliveira
José G G
JG
Sampaio
S
S
Borges
C
C
Tavares
I
I
Pestana
M
M
Almeida
M D V
MD
D000328:Adult; D001823:Body Composition / Q000502:physiology*; D003401:Creatine / Q000378:metabolism; D017097:Electric Impedance; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D013997:Time Factors
D003401:Creatine