Abstract
BACKGROUND: Chronic kidney disease (CKD) is characterized by accelerated aging, but the age-related changes in body composition and its modification by sex and race are unclear. METHODS: We assembled a cohort of 516 patients with CKD and 45 healthy controls and serially measured body composition using air-displacement plethysmography for up to 6 years. Mixed models were used to evaluate simultaneously the baseline and longitudinal changes in body composition as influenced by age, sex and race. RESULTS: Compared with healthy controls, patients with CKD had a greater weight, body mass index (BMI), fat mass (FM) and percent body fat (BF%), but the changes over time in body composition were similar. Older age (>60 years) was a strong determinant of loss of weight, BMI, FM and fat-free mass (FFM), but not BF%. Compared with non-blacks, blacks had a higher FFM at baseline, but they lost FFM more rapidly. Compared with women, men had an accelerated loss of FFM and accumulation of FM. Taking interactions into account, we found that young black men had no significant change in weight due to the loss of FFM and the accumulation of FM, thereby masking obesity by conventional measurements. CONCLUSION: Among patients with CKD, the changes in body composition are influenced by age, sex and race. Young black men have changes in body composition that may remain undetectable by conventional methods thus masking the occurrence of obesity.