Anne-Elisabeth Heng1, Christophe Montaurier2, Noël Cano3, Nicolas Caillot4, A Blot2, Nathalie Meunier2, Bruno Pereira5, Geoffroy Marceau6, Vincent Sapin6, Christelle Jouve2, Yves Boirie3, Patrice Deteix7, Beatrice Morio8. 1. CHU Clermont-Ferrand, Service de Néphrologie, Pôle REUNNIRH, F-63003 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France. Electronic address: aheng@chu-clermontferrand.fr. 2. INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France. 3. INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Nutrition Clinique, Pôle REUNNIRH, F-63003 Clermont-Ferrand, France. 4. NRC Medical, F-63450 Saint Saturnin, France. 5. CHU Clermont-Ferrand, Biostatistics Unit, Délégation Recherche Clinique et Innovation, F-63000 Clermont-Ferrand, France. 6. CHU Clermont-Ferrand, Laboratoire de Biochimie, F-63003 Clermont-Ferrand, France. 7. CHU Clermont-Ferrand, Service de Néphrologie, Pôle REUNNIRH, F-63003 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France. 8. INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France.
Abstract
BACKGROUND & AIMS: Alterations in energy metabolism could trigger weight gain after renal transplantation. METHODS: Nineteen transplanted non-diabetic men, 53 ± 1.6 years old, receiving calcineurin inhibitors but no corticosteroids were studied. They were compared with nine healthy men matched for height, age and lean body mass. Daily energy expenditure and its components (sleeping, basal and absorptive metabolic rates) were analyzed for 24 h in calorimetric chambers and for 4 days in free living conditions using calibrated accelerometry. Other variables known to influence energy expenditure were assessed: body composition, physical activity, 4-day food intake, drug consumption, serum C-reactive protein, interleukin-6, thyroid and parathyroid hormones, and epinephrine. Transplant recipients who gained more than 5% body weight after transplantation (n = 11, +11.0 ± 1.5 kg) were compared with those who did not (n = 8) and with the controls. RESULTS: Weight gain compared with non-weight gain patients and controls exhibited higher fat mass without change in lean body mass. Daily, sleeping and resting energy expenditure adjusted for lean body mass was significantly higher in non-weight gain (167.1 ± 4.2 kJ/kg/lean body mass/24 h, P < 0.05) compared with weight gain patients (147.4 ± 3.6) and controls (146.1 ± 4.6). Weight gain compared with controls and non-weight gain subjects had lower free living physical activity and a higher consumption of antihypertensive drugs and β-blockers. CONCLUSIONS: After kidney transplantation, weight gain patients were characterized by lower adjusted energy expenditure, reduced spontaneous physical activity but a more sedentary life style and a trend toward a higher energy intake explaining the reason they gained weight. The nWG KTR had increased resting and sleeping EE which protected them from weight gain. Such hypermetabolism was also observed in 24-h EE measurements. By comparison with the nWG patients, the WG transplant recipients were characterized by higher β-blocker consumption. These data could be helpful in the prevention of weight gain in kidney transplant recipients.
BACKGROUND & AIMS: Alterations in energy metabolism could trigger weight gain after renal transplantation. METHODS: Nineteen transplanted non-diabeticmen, 53 ± 1.6 years old, receiving calcineurin inhibitors but no corticosteroids were studied. They were compared with nine healthy men matched for height, age and lean body mass. Daily energy expenditure and its components (sleeping, basal and absorptive metabolic rates) were analyzed for 24 h in calorimetric chambers and for 4 days in free living conditions using calibrated accelerometry. Other variables known to influence energy expenditure were assessed: body composition, physical activity, 4-day food intake, drug consumption, serum C-reactive protein, interleukin-6, thyroid and parathyroid hormones, and epinephrine. Transplant recipients who gained more than 5% body weight after transplantation (n = 11, +11.0 ± 1.5 kg) were compared with those who did not (n = 8) and with the controls. RESULTS:Weight gain compared with non-weight gainpatients and controls exhibited higher fat mass without change in lean body mass. Daily, sleeping and resting energy expenditure adjusted for lean body mass was significantly higher in non-weight gain (167.1 ± 4.2 kJ/kg/lean body mass/24 h, P < 0.05) compared with weight gainpatients (147.4 ± 3.6) and controls (146.1 ± 4.6). Weight gain compared with controls and non-weight gain subjects had lower free living physical activity and a higher consumption of antihypertensive drugs and β-blockers. CONCLUSIONS: After kidney transplantation, weight gainpatients were characterized by lower adjusted energy expenditure, reduced spontaneous physical activity but a more sedentary life style and a trend toward a higher energy intake explaining the reason they gained weight. The nWG KTR had increased resting and sleeping EE which protected them from weight gain. Such hypermetabolism was also observed in 24-h EE measurements. By comparison with the nWG patients, the WG transplant recipients were characterized by higher β-blocker consumption. These data could be helpful in the prevention of weight gain in kidney transplant recipients.
Authors: Dorien M Zelle; Gerald Klaassen; Edwin van Adrichem; Stephan J L Bakker; Eva Corpeleijn; Gerjan Navis Journal: Nat Rev Nephrol Date: 2017-01-31 Impact factor: 28.314