P56
NUTRITIONAL STATUS, BODY COMPOSITION & ENERGY EXPENDITURE IN
KIDNEY TRANSPLANT RECIPIENTS
Chan, W1, 2, Kaur, O3, Phillips, A2, Borrows, R3
1
Department of Nutrition & Dietetics, Queen Elizabeth Hospital Birmingham, 2School of
Sport & Exercise Sciences, University of Birmingham, 3Department of Nephrology &
Kidney Transplantation, Queen Elizabeth Hospital Birmingham
BACKGROUND: Nutritional status and body composition have not been well investigated in
kidney transplant recipients (KTRs). Malnutrition and obesity following kidney transplantation
(KT) is associated with increased morbidity and mortality. Energy expenditure and metabolic
rate in KTRs have not been explored.
OBJECTIVES: To investigate the evolution of nutritional status, body composition, energy
expenditure and metabolic rate following KT.
METHODS: This is a longitudinal study. Living donor KTRs, n=26, 58% male and 42%
female, mean age = 42 years, were assessed within 1 month prior to KT (baseline), at 3- and 12months post KT. Nutritional status and body composition were measured by 7-point subjective
global assessment (SGA), handgrip strength (HGS), weight (WT), body mass index (BMI),
waist circumference (WC), waist-hip ratio (WHR), neck circumference (NC), triceps skinfold
thickness (TST), mid-arm muscle circumference (MAMC), and bio-impedance measurements
of lean tissue index (LTI) and fat tissue index (FTI). Average daily energy expenditure (EE)
and metabolic rate measured as metabolic equivalent task (METs) were assessed by wearing
metabolic and physical activity monitor “SenseWear Armband” for 3 consecutive days.
RESULTS: Paired sample t-test was used to compare nutritional status, body composition, EE
and METs between baseline, 3- and 12- months post KT. Results are shown in the following
table:
SGA
HGS (kg)
WT (kg)
BMI (kg/m2)
WC (cm)
WHR
NC (cm)
TST (mm)
MAMC (cm)
LTI (kg/m2)
FTI (kg/m2)
EE (kcal)
METs
Baseline
6.1
27.2
76.3
26.4
93.6
0.91
36.8
22.0
22.9
15.1
11.2
2485
1.3
3-months post KT
6.6
27.6
78.3
26.9
95.3†
0.93
37.4†
23.7
23.2
14.4†
12.2†
2870†
1.5
12-months post KT
6.9*
30.9
81.1
27.8
98.5*
0.94
38.0*
23.9
23.6
15.4§
12.3*
3050*
1.8©
*
p<0.05 (between
baseline and 12months post KT)
†
p<0.05 (between
baseline and 3months post KT)
§
p<0.01 (between
3- and 12- months
post KT)
©
p<0.01 (between
baseline and 12months post KT)
CONCLUSION: Nutritional status improved following KT. Overall, visceral and upper-body
adiposity increased following KT despite hyper-metabolism. Such increase is accompanied by
reduction in lean muscle mass during early stages post KT. Timely intervention targeting
adiposity is necessary to reduce long-term morbidity and mortality. Future research should
assess changes in dietary intake following KT and its impact upon body composition.