Vol.:(0123456789) 1 3 Journal of Nephrology https://doi.org/10.1007/s40620-018-0483-5 ORIGINAL ARTICLE Assessment of physical performance and body composition in male renal transplant patients Andrea Petronio Rossi 1  · Gianluigi Zaza 2,4  · Marina Zanardo 1  · Francesco Pedelini 1  · Laura Dalla Verde 1  · Chiara Caletti 2  · Alessia D’Introno 3  · Antonio Lupo 2  · Mauro Zamboni 1 Received: 14 December 2017 / Accepted: 22 February 2018 © Italian Society of Nephrology 2018 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 efect are not completely defned. 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 frst time, that clinically stable RTX recipients have greater muscle strength than dialyzed patients and suggests that the handgrip test could be an efective and easy-to-perform tool to assess changes in physical performance in this large patient population. Keywords Renal transplantation · Physical performance · Body composition · Chronic kidney disease · Handgrip strength Introduction Chronic kidney disease (CKD) is a major clinical feature of nephrology patients and it represents a foremost and rising challenge for healthcare systems. The prevalence rates of CKD appear to be growing globally [1] primarily as a conse- quence of the increased incidence of diabetes, hypertension, and an aging population [2]. Uremia per se and CKD-associated comorbidities have a signifcant negative impact on daily life performance and body composition associated with a self-perceived poor quality of life. This condition could be in part related to the presence of sarcopenia and obesity [3]. Data from a large longitudinal epidemiological study [4] have shown that patients with CKD experience a loss of muscle that occurs early compared to healthy subjects of the same age [4]. This Andrea Petronio Rossi and Gianluigi Zaza have contributed equally to this work. * Gianluigi Zaza gianluigi.zaza@univr.it 1 Division of Geriatrics, Department of Medicine, University of Verona, Verona, Italy 2 Renal Unit, Department of Medicine, University of Verona, Verona, Italy 3 Division of Geriatrics, Department of Medicine, University of Bari, Bari, Italy 4 Renal Unit, Department of Medicine, University of Verona, Piazzale A. Stefani, 1, 37126 Verona, VR, Italy