Combination Therapy with BCAA Intake and Physical Therapy Improved Leg Strength in Japanese Elderly Kidney Transplant Recipients Diagnosed as Sarcopenia.
Hitomi Sasaki1, Mamoru Kusaka1, Naohiko Fukami1, Manabu Ichino1, Kiyoshi Takahara1, Ryoichi Shiroki1, Kiyotaka Hoshinaga1.
1Urology, Fujita Health University, Toyoake, Japan
Introduction and Objectives: Sarcopenia has been defined as involuntary loss of skeletal muscle mass, strength and function. Chronic kidney disease is one of risk factors of sarcopenia. Especially in elderly kidney transplantation (KTx) recipients, a long term of chronic renal failure before transplantation and immunosuppression must be risk factors for developing sarcopenia. METHODS: In this study, we investigated the state of sarcopenia in Japanese elderly KTx patients and proved the effect of combination therapy with BCAA intake and exercise for recover leg strength. One hundred twenty eight KTx patients were measured body muscle mass using bioimpedance analysis (BIA) device (Inbody430, Takumi, Japan).In 38 KTx recipients(25 male,13 female) over 60 y.o, sarcopenia diagnosis was made according to European Working Group on Sarcopenia in Older People (EWSOG) criteria. Combination therapy with BCAA intake (7500mg/week) and exercise (cycle ergometer and resistance training) was administered to 10 elderly KTx patients diagnosed as sarcopenia. Hip Flexion,Hip Abduction, Knee Extention, Ankle Plantarflexion were measured by HandHeld dynamometer before and 12 weeks after combination therapy.
Results: In 128 KTx recipients, average of total body muscle volume was 23.05kg, total body fat volume was 13.8kg and %BMI was 19.3kg/m2. Their body weight (54.9kg) and %BMI (21.9kg/m2) were well controled. However, adjustment of muscle mass was +4.1kg and fat was -4.28kg. Twenty six (68.4%) in 38 patients aged over 60y.o was diagnosed as sarcopenia in accordance with EWSOG diagnostic criteria including gait speed, grip strength and muscle mass. After 12 weeks combination physical therapy administration, strength of Hip Flexion,Hip Abduction, Knee Extention, Ankle Plantarflexion were increased significantly(p=0.04,0.02,0.01,0.05).
Conclusion: In conclusion,Japanese renal transplant recipients was in a state of so-called sarcopenia obesity. In patients over 60 years old, 68% were diagnosed as sarcopenia. Combination therapy with BCAA and physical therapy improved increasing leg strength for 12 weeks.
