Andrea Petronio Rossi1, Gianluigi Zaza2,3, Marina Zanardo1, Francesco Pedelini1, Laura Dalla Verde1, Chiara Caletti4, Alessia D'Introno5, Antonio Lupo4, Mauro Zamboni1. 1. Division of Geriatrics, Department of Medicine, University of Verona, Verona, Italy. 2. Renal Unit, Department of Medicine, University of Verona, Verona, Italy. gianluigi.zaza@univr.it. 3. Renal Unit, Department of Medicine, University of Verona, Piazzale A. Stefani, 1, 37126, Verona, VR, Italy. gianluigi.zaza@univr.it. 4. Renal Unit, Department of Medicine, University of Verona, Verona, Italy. 5. Division of Geriatrics, Department of Medicine, University of Bari, Bari, Italy.
Abstract
BACKGROUND: Renal transplant (RTX) recipients seem to experience a better quality of life compared to dialysis patients. However, the factors responsible for this positive effect are not completely defined. Conceivably, a change in the physical performance of these patients could play a role. METHODS: To assess this, we measured: (1) waist circumference, fat mass and appendicular fat-free mass (aFFM) by dual-energy X-ray densitometry, (2) physical performance with the Short Physical Performance Battery, and (3) muscle strength with the handgrip test, in 59 male RTX, 11 chronic kidney disease in conservative treatment (CKD) and 10 peritoneal dialysis (PD) patients. RESULTS: Surprisingly, anthropometric characteristics and body composition were similar among the three groups. However, despite a low aFFM, muscle strength was higher in stable RTX recipients > 5 years after transplantation than in dialyzed patients. Instead, CKD (wait-listed for RTX) had similar muscle strength to RTX patients. Waist circumference in RTX recipients showed a redistribution of body fat with increased central adipose tissue allocation compared to PD. At linear regression analysis, age, weight, height, aFFM, hemoglobin and transplant age were independent predictors of handgrip strength, explaining about 37% of the variance. Age and transplant age accounted for 18 and 12% of variance, respectively. CONCLUSIONS: Our study demonstrates, for the first time, that clinically stable RTX recipients have greater muscle strength than dialyzed patients and suggests that the handgrip test could be an effective and easy-to-perform tool to assess changes in physical performance in this large patient population.
BACKGROUND: Renal transplant (RTX) recipients seem to experience a better quality of life compared to dialysis patients. However, the factors responsible for this positive effect are not completely defined. Conceivably, a change in the physical performance of these patients could play a role. METHODS: To assess this, we measured: (1) waist circumference, fat mass and appendicular fat-free mass (aFFM) by dual-energy X-ray densitometry, (2) physical performance with the Short Physical Performance Battery, and (3) muscle strength with the handgrip test, in 59 male RTX, 11 chronic kidney disease in conservative treatment (CKD) and 10 peritoneal dialysis (PD) patients. RESULTS: Surprisingly, anthropometric characteristics and body composition were similar among the three groups. However, despite a low aFFM, muscle strength was higher in stable RTX recipients > 5 years after transplantation than in dialyzed patients. Instead, CKD (wait-listed for RTX) had similar muscle strength to RTX patients. Waist circumference in RTX recipients showed a redistribution of body fat with increased central adipose tissue allocation compared to PD. At linear regression analysis, age, weight, height, aFFM, hemoglobin and transplant age were independent predictors of handgrip strength, explaining about 37% of the variance. Age and transplant age accounted for 18 and 12% of variance, respectively. CONCLUSIONS: Our study demonstrates, for the first time, that clinically stable RTX recipients have greater muscle strength than dialyzed patients and suggests that the handgrip test could be an effective and easy-to-perform tool to assess changes in physical performance in this large patient population.
Authors: Carmelo Libetta; Vincenzo Sepe; Pasquale Esposito; Francesco Galli; Antonio Dal Canton Journal: Clin Biochem Date: 2011-07-12 Impact factor: 3.281
Authors: Baback Roshanravan; Cassianne Robinson-Cohen; Kushang V Patel; Ernest Ayers; Alyson J Littman; Ian H de Boer; T Alp Ikizler; Jonathan Himmelfarb; Leslie I Katzel; Bryan Kestenbaum; Stephen Seliger Journal: J Am Soc Nephrol Date: 2013-04-18 Impact factor: 10.121