Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-Ku, Daegu, 42415, Republic of Korea.
Int Urol Nephrol. 2021 Feb;53(2):383-390. doi: 10.1007/s11255-020-02713-6. Epub 2021 Jan 2.
Serial follow-up data of body composition from peritoneal dialysis (PD) initiation until 1 year after kidney transplantation (KT) would be useful in identifying pathologic or physiologic changes, related to each modality or during the exchange of the modality.
Body composition analysis was performed 1 month after PD initiation, repeated annually, immediately before KT, 1 month and 1 year after KT (n = 43). Body composition analysis was performed using a bioimpedance analysis (BIA) machine. The body composition parameters measured using BIA included the water contents, fat mass index (FMI), appendicular muscle mass index (aMMI), and bone mineral content (BMC).
The aMMI values 1 month and 1 year after PD initiation, immediately before KT, and 1 month and 1 year after KT were 7.6 ± 1.5, 7.8 ± 1.4, 8.0 ± 1.4, 6.8 ± 0.9, and 7.0 ± 1.0 kg/m, respectively. The aMMI increased during the first year of PD (P = 0.029) and was maintained during the remaining period of PD (P = 0.413). The value decreased during the first month after KT (P < 0.001) and recovered during the first year after KT (P = 0.010). FMI increased during the first year of PD (P < 0.001) and was maintained during the remaining period of PD (P = 0.214). The value increased during the first year of KT (P < 0.001). BMC was stable during the PD period but decreased after KT. Body waters were maintained during PD and decreased after KT. The presence of low muscle mass (LMM) 1 month after PD initiation or 1 month after KT, was associated with development of LMM 1 year after KT.
Our study showed that body composition was significantly changed during the first year after PD or the first month after KT, as evidenced by a decrease in aMMI and BMC and an increase in FMI. Adequate interventions provided at these two points might help maintain proper body composition.
从腹膜透析（PD）开始到肾移植（KT）后 1 年的连续随访数据，对于识别与每种治疗模式相关的或在治疗模式转换期间发生的病理或生理变化将非常有用。
在 PD 开始后 1 个月、每年重复一次、KT 前、KT 后 1 个月和 1 年进行身体成分分析（n=43）。使用生物电阻抗分析（BIA）机器进行身体成分分析。BIA 测量的身体成分参数包括水含量、脂肪质量指数（FMI）、四肢肌肉质量指数（aMMI）和骨矿物质含量（BMC）。
PD 开始后 1 个月和 1 年、KT 前、KT 后 1 个月和 1 年的 aMMI 值分别为 7.6±1.5、7.8±1.4、8.0±1.4、6.8±0.9 和 7.0±1.0 kg/m。aMMI 在 PD 的第一年增加（P=0.029），并在 PD 的剩余时间保持不变（P=0.413）。在 KT 后第一个月下降（P<0.001），并在 KT 后第一年恢复（P=0.010）。FMI 在 PD 的第一年增加（P<0.001），并在 PD 的剩余时间保持不变（P=0.214）。在 KT 的第一年增加。BMC 在 PD 期间保持稳定，但在 KT 后下降。PD 期间保持体水，KT 后下降。PD 开始后 1 个月或 KT 后 1 个月出现低肌肉量（LMM）与 KT 后 1 年出现 LMM 有关。
我们的研究表明，在 PD 后第一年或 KT 后第一个月，身体成分发生了显著变化，表现为 aMMI 和 BMC 下降，FMI 增加。在这两个时间点进行适当的干预可能有助于维持适当的身体成分。
