Evaluation of Sarcopenia in Renal Transplant Recipients

BACKGROUND: Chronic kidney disease can lead to sarcopenia; however, no study has described sarcopenia in the patients undergoing renal transplantation. OBJECTIVES: The aim of the present study was to assess the prevalence of sarcopenia in renal transplant recipients (RTR) and to evaluate the demographic and metabolic risk factors associated with sarcopenia in these patients. PATIENTS AND METHODS: Sarcopenia was diagnosed by measuring handgrip strength in 166 RTR (68 females and 98 males; mean age, 37.9 ± 11.9 years). Basal metabolic rate, fat mass, free-fat mass, total body water, body mass index, and calf circumference were determined, along with blood biochemistry, vitamin D levels, and glomerular filtration rate. RESULTS: Among 166 patients, sarcopenia was present in 34 (20.5%). Handgrip, basal metabolic rate, free fat mass, and total body water were significantly lower in patients with sarcopenia in comparison with those without sarcopenia. There were no differences between patients with and without sarcopenia in terms of mean time since transplantation, the presence of diabetes mellitus, hypertension, coronary artery disease, hyperlipidemia, glomerular filtration rate, and body mass index. Univariate analysis revealed significant differences between patients with and without sarcopenia with respect to age (mean of 43.70 ± 13.97 and 36.37 ± 10.82 years, respectively; P = 0.007) and 25-OH vitamin D levels (median (IQR) of 12 (2-39) and 17.70 (3-68) μg/L, respectively; P = 0.024). There was a statistically significant positive correlation between vitamin D levels and handgrip strength (r = 0.334; P < 0.001). Multivariate regression analysis determined that age was an independent predictive variable of sarcopenia in RTR (β = 1.060; 95% CI, 1.017-1.105; and P = 0.006). CONCLUSIONS: Chronic renal disease contributes to sarcopenia, which may develop at an earlier age in RTR.