Objectives: Long-term graft and patient survival after kidney transplant is affected by metabolic disorders such as hypertension, obesity and diabetes. The aim of this study was to understand the effect of postoperative exercise therapy on changes in body composition after kidney transplantation.

Methods: 20 recipients were included in the study. Continuous exercise therapy by a physical therapist with feedbacks of physical ability tests was performed. Body composition was measured sequentially using an impedance analyzer at the following points: pretransplant (just after dialysis), 1 month, 3 months and 6 months after transplant. Body weight (BW), body mass index (BMI), the ratio of the extracellular water to the total water mass (ECW/TW), the ratio of ECW to BW (ECW/BW), the amount of body fat (BF) and muscle mass (MM). Exercise instruction course were also conducted for each recipient at each time point.

Results: Pretransplant average BMI was 23.5±4.1. BW decreased from 64.7kg pretransplantly to 61.3kg at 1 month. Both TW and ECW decreased and ECW/TW remained stable at 39%. BW and TW did not show change after 1 month. On the other hand, MM decreased from 28.1kg pretransplantly to 26.0kg at 1 month but recovered thereafter. BF remained stable at the average of 13kg throughout the period.

Conclusions: BW loss early after kidney transplant is mainly due to the reduction of ECW and is also partly due to significant loss of MM by postoperative bed rest and malnutrition. Aggressive nutritional and exercise intervention starting immediate after transplantation is important to avoid muscle loss and relative increase in body fat ratio.

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