Nutrition for the post–renal transplant recipients (original) (raw)
Related papers
Nutritional Consequences of Renal Transplantation
Journal of Renal Nutrition, 2009
Successful kidney transplantation leads to restoration of renal function. Some metabolic disorders from chronic renal failure may persist and new metabolic abnormalities can develop (obesity, diabetes, hypertension, bone disease, and anemia). Additionally, influence of immunosuppressive drugs (corticosteroids, cyclosporine A, tacrolimus, and rapamycin) may aggravate the course of diabetes, hypertension, and dyslipidemia. Nutritional management of renal transplantation is divided into the pretransplant period, transplant surgery, and early and late posttransplant period. Patients in the pretransplant period in dialysis treatment may develop protein-energy malnutrition and negative nitrogen balance, with loss of lean body mass and fat deposits. Nutritional management in the early posttransplant period with a functioning kidney graft necessitates fluid and electrolyte balance control with protein intake of 1,2/kg BW/day and 30-35 kcal/kg BW/day. In a nonfunctioning kidney graft, dialysis treatment continues and the therapeutic dose of immunosuppressive drugs must be reduced. The principal objective in the late posttransplant period is the maintenance of optimal nutritional status. Nutrition is important in managing obesity, insulin resistance, diabetes, hyperlipidemia, and hypertension. Other posttransplant conditions for which diet and/or nutritional supplements may be beneficial include hypomagnesemia, hypophosphatemia, hyperuricemia, hyperkalemia, hyperhomocysteinemia, chronic renal allograft failure, renal anemia, and renal bone disease.
Nephrology Dialysis Transplantation, 2007
Background. In these last years, several traditional risk factors for cardiovascular disease, like obesity, dyslipidaemia, hypertension and post-transplant diabetes mellitus have been also identified as important nonimmunological risk factors leading to the development of chronic allograft nephropathy, the first cause of graft loss in transplanted patients. The aim of the present study was to determine the effects of a 12-month dietary regimen on the nutritional status and metabolic outcome of renal transplant recipients in the first post-transplant year. Methods. Forty-six cadaver-donor renal transplant recipients (mean age 40.8 AE 10.1-years), enrolled during the first post-transplant year (4.8 AE 3.3 months) and followed prospectively for a 12 month period. Biochemical and nutritional markers, anthropometric measurements, body composition (by conventional bioelectrical impedance analysis) and dietary records (using a detailed food-frequency questionnaire) at baseline and after 12 months. Results. Compliance to the diet was related to sex (male better than female) and was associated with weight loss primarily due to a decrease in fat mass, with decrease in total cholesterol and glucose plasma levels and with a concomitant rise in serum albumin. Conclusion. After renal transplantation, health benefits of proper metabolic balance that include reduced body fat, weight loss, lower cholesterol and triglycerides levels and an improvement, fasting glucose levels can be obtained when dietary intervention occurred.
Nutritional status of renal transplant patients
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2002
To assess the effect of renal transplantation on the nutritional status of patients. Prospective descriptive study. Renal Transplant Clinic at Tygerberg Hospital, Western Cape. Fifty-eight renal transplant patients from Tygerberg Hospital were enrolled in the study. The sample was divided into two groups of 29 patients each: group 1, less than 28 months post-transplant; and group 2, more than 28 months post-transplant. Nutritional status assessment comprised biochemical evaluation, a dietary history, anthropometric measurements and a clinical examination. Serum vitamin B6 levels were below normal in 56% of patients from group 1 and 59% from group 2. Vitamin B6 intake, however, was insufficient in only 14% of patients from group 1 and 10% from group 2. Serum vitamin C levels were below normal in 7% of patients from group 1 and 24% from group 2, while vitamin C intake was insufficient in 21% and 14% of patients from groups 1 and 2 respectively. Serum magnesium levels were below normal...
Kidney transplantation is the preferred modality of renal replacement therapy. Long-term patient-and graft-survival have only improved marginally over the recent decade, mainly due to the development of cardiovascular disease following transplantation. Obesity is a risk factor for cardiovascular disease, and is common pre-and post-transplantation. This article reviews the literature assessing the role of pre-and post-transplant obesity on patient-and graft-survival, discusses the underlying obesity-related mechanisms leading to inferior kidney transplant outcomes, and explores the role of nutritional intervention on improving long-term outcomes of transplantation. While the role of pre-transplant obesity remains uncertain, post-transplant obesity increases the risk of graft failure and mortality. Nutritional intervention is effective in achieving post-transplant weight loss, but the impact on long-term outcomes has not been established. Future research should focus on conducting nutritional intervention studies aiming to improve long-term outcomes of kidney transplantation.
Post–Renal Transplantation Weight Gain: Its Causes and Its Consequences
Transplantation Proceedings, 2005
Objective. A tendency to increased body mass index (BMI) occurs after renal transplantation. The objective of this study was to analyze the causes and consequences of this weight gain. Methods. Two hundred twelve renal transplant recipients were divided into 3 groups according to the evolution of their BMI: BMI loss (group 1); BMI increase Ͻ10% (group 2); and BMI increase Ͼ10% (group 3). Results. The mean BMI gain was 6.2%, weight gain was 3.9 kg, and BMI gain was 1.4 kg/m 2. The patients in group 3 were younger, but there were no other significant differences in gender, preoperative diabetes, acute rejection, or prior BMI. Blood pressure was similar in all 3 groups, but more group 3 patients needed antihypertensive treatment. A progressive increase in total and low-density lipoprotein (LDL)-cholesterol was also observed as patients showed increased BMI. No differences were observed regarding carbohydrate metabolism. Groups 1 and 3 showed a more unfavorable micro-inflammatory profile. The creatinine clearance level was better in group 3 compared with group 1. We found no differences regarding the number of nonfatal postoperative cardiovascular events.
Comorbidity and kidney graft failure—two main causes of malnutrition in kidney transplant patients
2000
Background. Malnutrition is very frequent in chronic renal failure but, after successful kidney transplanta- tion, body weight gain is common and is widely investigated, while malnutrition after transplantation is underestimated. In the present study, the prevalence of malnutrition in kidney transplant patients and the factors which might contribute to its development are analysed. Method. In a population of 452 kidney
2020
Kidney transplantation is usually performed as a preferred treatment and last resort in chronic kidney disease after the end stage of renal disease. Considering that nutrition can play an essential role in post-transplant recovery, the aim of this study was to review the nutritional assessment and dietary requirements of kidney transplant patients. Articles were collected via searching in databases such as PubMed-Medline, Google Scholar, Scopus, and Web of Science using relevant keywords and phrases, including kidney transplantation, end stage renal disease, nutrition, dietary intake, nutritional assessment, and nutrition evaluation. Medical nutrition therapy can play a vital role in the recovery after transplantation in kidney failure patients. It seems that nutritional and medical evaluation through laboratory methods, vital signs, and anthropometric measurements are necessary to improve the quality of nutritional interventions after kidney transplantation and can help to decrease...
Weight Gain After Renal Transplantation is a Risk Factor for Patient and Graft Outcome
Transplantation, 2004
Background. The present study aimed to evaluate the effect of weight gain after transplantation on patient and graft outcome. Methods. Patients receiving kidney transplants between April 1986 and April 2001 were divided according to their body mass index (BMI) at 6 months after transplantation into group I, BMI less than 25 (normal weight); group II, BMI greater than or equal to 25 and less than 30 (overweight); and group III, BMI greater than or equal to 30 (obese) after exclusion of pediatric patients (aged <18 years), second transplant recipients, those with a history of cardiovascular disease, and those with a BMI less than 25 and greater than 18.5 kg/m 2. Six hundred fifty kidney transplant recipients were selected for this retrospective study. Results. There was a statistically significant increase in the incidence of posttransplant hypertension, diabetes mellitus, and ischemic heart disease in the obese group. The incidence and frequency of acute rejection episodes were similar in the three groups. A trend toward decreased graft and patient survival, which reached significance at 5 years and 10 years, was observed in the obese group. Conclusions. BMI has a strong association with outcomes after renal transplantation independent of most of the known risk factors for patient and graft survival.
Nutritional Status and Body Composition in Patients Early After Renal Transplantation
Transplantation Proceedings, 2012
Hepatic glycogen storage diseases (GSDs) are genetic diseases associated with fasting hypoglycemia. Periodic intake of uncooked cornstarch is one of the treatment strategies available for those disorders. For reasons that are still not clear, patients with hepatic GSDs may be overweight. Aims: To assess nutritional status and body composition in patients with hepatic GSDs receiving uncooked cornstarch. Methods: The sample included 25 patients with hepatic GSD (type Ia ¼ 14; Ib ¼ 6; III ¼ 3; IXa ¼ 1; IXb ¼ 1), with a median age of 11.0 years (interquartile range [IQR] ¼ 9.0-17.5), matched by age and gender with 25 healthy controls (median age ¼ 12.0 years, IQR ¼ 10.0-17.5). Clinical, biochemical, and treatment-related variables were obtained from medical records. Nutritional status and body composition were prospectively evaluated by bioelectrical impedance. Results: Patients and controls did not differ with regard to age and gender. Height was significantly reduced in patients (median ¼ 1.43 m, IQR ¼ 1.25-1.54) in comparison to controls (median ¼ 1.54 m, IQR ¼ 1.42-1.61; P ¼ .04). Body mass index for age z-score and fat mass percentage were higher in patients (median ¼ 1.84, IQR ¼ 0.55-3.06; and 27.5%, IQR ¼ 22.6-32.0, respectively) than in controls (median ¼ 0.86, IQR ¼ À0.55 to 1.82; P ¼ .04 and 21.1%, IQR ¼ 13.0-28.3; P ¼ .01, respectively). When patients were stratified by type, those with GSD Ia had significantly higher adiposity (median fat mass ¼ 28.7%, IQR ¼ 25.3-32.9) than those with GSD III and GSD IXa/b (median fat mass ¼ 20.9%, IQR ¼ 14.9-22.6; P ¼ .02). Conclusions: Our findings suggest that patients with hepatic GSD on treatment with cornstarch, especially those with GSD Ia, exhibit abnormalities in nutritional status and body composition, such as short stature and a trend toward overweight and obesity.