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Kidney Week

Abstract: TH-PO978

Dynamics of Changing Nutritional Status following Kidney Transplantation

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Sukackiene, Diana, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
  • Miglinas, Marius, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
Background

Kidney transplantation (KTx) is the optimal treatment for end-stage renal disease (ESRD) which improving patient survival, yet nutritional and metabolic disorders in patients both before and after KTx are an important clinical and scientific problem. Our study aimed to assess the nutritional status and body composition of candidates for kidney transplantation before the surgery and 12 months after it, to analyse the changes.

Methods

Prospective, observational study was conducted in a tertiary reference hospital. The nutritional status of the patients was assessed by performing laboratory tests, anthropometric measurements, and body composition analysis by using the Bioelectrical Impedance Analysis (BIA), measuring the handgrip strength (HGS), and filling out malnutrition (MN) screening tools on the day of KTx, 6 and 12 months after it.

Results

A total of 98-kidney transplant patients (mean age of 43 [20;60] years, 55 % male, 10 % with diabetes) were included. 52 % of the subjects were overweight or obese before KTx and only 4 % had BMI less than 18.5 kg/m2 . The baseline screening showed the prevalence of malnutrition prior to the KTx ranged from 7 to 40 %, depending on the screening questionnaire. When assessing the nutritional risk after KTx - the frequency of a low or mild risk of MN is reduced, and more patients achieve a good nutritional status and subsequently lose the risk of MN (87–98%). In the female population, HGS significantly decreased when assessed before KTx and after 6 months (26.2 ± 6 kg and 24.1 ± 6 kg, p < 0.01), as well as after 12 months (26.2 ± 6 kg and 24.2 ± 6.7 kg, p < 0.01). In men, a significant decline in HGS was observed only after 6 months (46.3 vs 44.1 kg, p < 0.01) A decrease in the muscle mass was found in 8% of males 6 months after the surgery, and in 4% of females 12 months after the surgery. This reduction in the muscle mass leads to a significant loss of fat free mass. During the 1-year follow up period we observed a significant increase in body weight (77.6 ± 17.6 kg vs 79.1 ± 18.3 kg), waist circumference (92.6 ± 15 cm vs 96.7 ± 16.2 cm), fat mass (14.4 [1.8-56.9] kg vs 17.3 [2-51.8] kg).

Conclusion

Kidney transplantation leads to changes in body composition that favor increasing body weight driven by fat mass accumulation, increased waist circumference and lean body mass loss.