Height-adjusted lean body mass and its associations with physical activity and kidney function in pediatric kidney transplantation.

Abstract

Although LBM is positively associated with health outcomes, studies assessing determinants for the accrual of ht-LBM, such as physical activity, are limited. This study aimed to assess ht-LBM levels in pediatric kidney transplant recipients and test its association with baseline and contemporaneous variables, including physical activity. A retrospective cross-sectional review was performed on 46 pediatric kidney transplant recipients, and a longitudinal review was performed on a subset of recipients with serial post-transplant (n=21) and pre/post-transplant (n=11) ht-LBM measurements. Ht-LBM measurements were obtained using DXA scans. This cohort was 16.0 (IQR 12.3, 17.7) years old, 56.5% male and 46±45months post-transplant with a mean ht-LBM of 15.1±2.5kg/m2 . A median ht-LBM increase of 1.6kg/m2 (IQR - 0.1, 2.6kg/m2 ; p<.01) was observed, over 29.2±12.0months from the earliest post-transplant scan obtained at 46±25months post-transplant until the most recent post-transplant scan. A 1.7±1.4kg/m2 (p<.01) increase was observed between pre- and post-transplant DXA scans which were taken at 12±11months pre-transplant and 13±6months post-transplant, respectively. In separate adjusted models, lower physical activity questionnaire scores (n=17, beta=1.55, p=.02), faster rate of estimated glomerular filtration rate decline (beta=0.05, p<.048) adjusted for annualized change in BSA, and younger age at scan (beta=0.32, p<.01) were each significant predictors of lower ht-LBM. Physical activity and kidney function may influence ht-LBM in the pediatric kidney transplant population.