Evaluation of Nutritional Status in Renal Transplant Recipients in Accordance to Changes in Graft Function

Abstract

Introduction and aims: Renal transplantation is the ultimate treatment modality for end stage renal disease and was reported to improve many complications associated with renal failure. Malnutrition is also a reversible process which usually resolves after transplantation. However there is insufficient data about body composition analyzes and nutritional status of renal transplantation recipients. In this study, we investigated the effect of graft function on nutritional status and body composition analysis in a group of renal transplant recipients. Methods: 189 renal transplant recipients (59 female, aged; 38.3 ± 10.6 years)who had a minimum posttransplantation follow-up duration of 12 months were included. All patients had an anthropometric and body composition analysis. Body compositions were analyzed by using the Body Composition Analyzer (Tanita BC-420MA). Monthly assessed biochemical parameters including anemia parameters, hemoglobin albumin, CRP, calcium, phosphorus, parathyroid hormone level, lipid profile of the last 6 months were retrospectively collected. Patients were divided into 2 groups according to GFR levels as normal function (group 1, GFR ≥ 90 mL/min, n: 59) and low renal function (group 2, GFR < 90 mL/min, n: 130) groups. Results: Study groups were in means of demographic characteristics. Group 2 patients had significantly lower waist-hip ratios and sagittal abdominal diameter (p:0.01 and 0.007 respectively) than group 1 patients. Group 2 patients had lower body weight (68.1±12.9 vs 77.7±4.4 kg) and lower BMI (24.9±5.3 vs 27±4.4) than group 1 patients (p:0,01). According to body composition analysis group 2 patients had significantly lower fat, muscle and bone mass values (p: 0.009, 0.0001, 0.0001 respectively). A correlation analysis revealed that GFR values were positively correlated with fat, muscle and bone mass values (r: 0.289, 0.283, 0.260 respectively, p:0.0001). GFR vales were also positively correlated with visceral fat ratio (r: 0.169, p:0.02), body mass index (r:0.253, p: 0.0001) and waist-hip ratio (r:0.218, p: 0.006). Group 2 had significantly lower albumin (p: 0.02), higher P (p: 0.05), lower calcium (0.001), higher iPTH (p: 0.029), lower hemoglobin (0.0001) levels compared to group 1. Conclusions: Our results indicate that mean predictor of nutrition after renal transplantation is graft function. As the graft function declines a significant decrease in body weight and body fat followed by a decreased in muscle mass is observed that triggers the development of malnutrition. Therefore nutritonal assessment should be mandatory in patients with failing grafts.