Abstract
We have recently demonstrated the validity of bioelectrical impedance (BI) analysis for assessing body composition in healthy and diseased children (Ped Res 29:350A). In order to study the effects of renal Tx and corticosteroid treatment on the body composition of children with chronic renal failure, we followed up 15 patients aged 3.2 to 18.5 (mean 11.4) years for the first 12 months after Tx. Measurements of height, weight and BI were taken at 2, 4, 6 and 8 weeks, and 3, 4, 6, 8, 10 and 12 months after Tx. Fat-free mass (FFM) was estimated from BI, according to a formula derived from previous validation studies using 40K plethysmography as reference standard. An age- and sex-independent analysis was achieved by transformation of the raw data to standard deviation scores (SDS) based on regional standards for height, weight and body composition. To allow for the non-Gaussian distribution of weight and fat mass (FM), separate SD values were calculated for subjects above and below the 50th percentile.
Average relative height was subnormal (-1.94 ± 1.8 SDS) and did not change during the first year after Tx. Relative weight for height increased during the first three months from -0.32 ± 1.0 to +0.42 ± 1.0 SDS (p<0.02), and changed only slightly thereafter. In contrast, relative FFM for height continued to increase from month 3 (-0.66 ± 0.9 SDS) to month 12 (+ 0.65 ± 1.2 SDS, p<0.01).
Our study demonstrates that during the first 3 months after Tx, when high corticosteroid doses are applied, weight gain is mainly due to an expansion of the FM. Subsequently, the anabolic effect of restored renal function becomes apparent by a marked increase of FFM.
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Schaefer, F., Hake, B., Schulte, R. et al. CHANGES OF BODY COMPOSITION IN CHILDREN FOLLOWING RENAL TRANSPLANTATION (TX). Pediatr Res 32, 625 (1992). https://doi.org/10.1203/00006450-199211000-00125
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DOI: https://doi.org/10.1203/00006450-199211000-00125