Assessment of body composition by dual-energy X-Ray absorptiometry in renal transplant patients, hemodialysis patients, and a control group of healthy subjects.

Abstract

Background: The clinical findings of patients with Chronic Kidney Disease (CKD), which is characterized by malnutrition, sedentary lifestyle, uremia, and catabolism associated with dialysis produce changes in Body Composition (BC), causing increased Fat Mass (FM), decreased in both Lean Mass (LM) and Body Mineral Density (BMD), even despite uremic reversal after a Kidney Transplant (KT); immunosuppressive medications alter BC, increasing the risk of loss of the kidney transplant and cardiovascular diseases.

Objective: To demonstrate whether there are differences in BC between a group of patients with KT and a group of patients on Hemodialysis (HD), when comparing them with a control group without the disease.

Materials and methods: In the present observational study, with a comparative design; 125 patients were evaluated (46 with KT, 47 on HD, and 32 from the healthy control group). The BC was evaluated with the full-body Dual-Energy X-Ray Absorptiometry (DEXA) method.

Results: The mean age and standard deviation (X±SD) of the study subjects were: 28.89 ± 5.76, 27.39 ± 5.04, and 29.63 ± 6.34 years for the HD, KT, and control subjects, respectively. The HD patients presented a total FM of 14.98 ± 6.96 kg in comparison with 20.1 ± 6.5 kg for the control group (p = 0.007), and 19.06 ± 7.94 kg for the group with KT (p = 0.02). The total LM was lower in the KT patients in comparison with the control group (p = 0.023). The content and total BMD were lower in both groups of patients with KT and HD.

Conclusions: Although a comprehensive improvement in BC was expected after kidney transplantation, the results are not close to "normal' values, when compared with those of healthy subjects of the same age.