Nutritional Status and Body Composition Evolution in Early Post–Renal Transplantation: Is There a Female Advantage? A. Coroas, J.G.G. Oliveira, S. Sampaio, C. Borges, I. Tavares, M. Pestana, and M.D.V. Almeida ABSTRACT Objective. Chronic renal failure is associated with metabolic derangements, affecting proteins, amino acids, and lipids. Usually these patients follow a restricted diet. Kidney transplant patients enjoy a recovery of renal function, but their therapeutics may entail significant changes in general metabolism. We compare the anthropometric results during the first 3 months after successful transplant for male and female patients versus a healthy group. Methods. Eighteen patients (11 men and 7 women) were studied. Anthropometry was assessed before and at month 1 and month 3 posttransplant including body weight (Wt), body mass index (BMI), triceps (TSF), biceps (BSF), subscapular (SCSF), and suprailiac skinfolds (SISF), midarm circumference (MAC), midarm muscle circumference (MAMC), corrected arm muscle area (CT.AMA), total body muscle mass (MM), body density (D), fat mass (FM), and fat-free mass (FFM). The healthy group was evaluated three times in the first year. Results. Pretransplant men showed lower Wt, BMI, TSF, BSF, SCSF, SISF, MAC, MAMC, CT.AMA, MM, FM and FFM than controls, while women displayed no differences from controls. By the third month, men showed only a partial recovery and women higher TSF and SCSF than controls. Conclusions. Uremic men before transplant displayed undernutrition indices. During the first 3 months posttransplant men showed an incomplete recovery of anthropometric parameters. Quite differently, women started close to normal and had significantly increased body weight and fat content posttransplant. We suggest that nutritional requirements post–kidney grafting may be significantly different among male compared to female patients. A S A RULE, recipients of a successful kidney allograft benefit from an improved health status, frequently along with weight gain, which is influenced by increased appetite and a reversal of the uremic state. 1,2 Within the early posttransplant period, the increased body dry weight is mainly due to an increase in body fat mass (FM). 2 This may be partly due to the relatively high doses of immunosup- pressive drugs used to maintain the renal allograft, espe- cially glucocorticoids and calcineurin inhibitors, which are known to be associated with metabolic side effects including muscle atrophy, obesity, hyperlipidemia, glucose intoler- ance, hypertension, hyperkalemia, hypophosphatemia, and hypomagnesemia. 1–5 Moreover, during this early postsur- gery period, the combined effects of reduced physical activity and higher nutritional compliance may enhance FM accumulation. Actually obesity is a major problem in the transplant recipient population. On the other hand, 15% to 20% of chronic renal patients present with mild to moder- ate obesity when they come to transplantation. One year after transplantation, 60% of recipients gain 10% or more From the Nephrology Department (A.C., J.G.G.O., S.S., C.B., I.T., M.P.), S João Hospital; Faculty of Nutrition and Food Sciences (A.C., M.D.V.A.), Porto University; Unit of Investigation and Development of Nephrology (A.C., J.G.G.O., M.P.); and Faculty of Medicine (J.G.G.O., M.P.), Porto University, Porto, Portugal. Address reprint requests to Andreia S.P.S. Coroas, Calçada da Arrábida No. 1 F-41, 4150-106 Porto, Portugal. E-mail: jcasimiro@mail.telepac.pt © 2005 by Elsevier Inc. All rights reserved. 0041-1345/05/$–see front matter 360 Park Avenue South, New York, NY 10010-1710 doi:10.1016/j.transproceed.2005.05.045 Transplantation Proceedings, 37, 2765–2770 (2005) 2765