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An Observational Study on the Clinical and Nutritional Factors Determining the Kidney Function at One Year after Transplantation

A kidney transplant is a surgery done to replace a diseased kidney with a healthy kidney from a donor. This surgery is a lifesaving choice for thousands of patients with endstage kidney disease (kidney renal failure). And kidney transplant recipients are usually managed with special care during the follow-up period. During the long-term follow-up phase, the risk of infection or acute rejection decreases with the stability of the renal function because the self-defense system is rebuilt in the recipient. In this study, the authors aimed to investigate the clinical and nutritional factors influencing the renal function of the transplanted kidney during a one-year follow-up period after transplantation.

The present prospective observational study included 52 patients who underwent kidney transplantation at Jichi Medical University Hospital from 2014 to 2016. The baseline characteristics of kidney donors and recipients were examined. The clinical and laboratory data (BMI, systolic blood pressure, diastolic blood pressure, serum Cr, HbA1c, albumin, uric acid, potassium, phosphorus, triglyceride, high density lipoprotein cholesterol and low density lipoprotein cholesterol concentrations) were determined at 1, 3, 6 and 12 months after transplantation. Low density lipoprotein cholesterol was calculated by Friedwald formula. Furthermore, the dietary protein and salt intake were measured at 3, 6 and 12 months after transplantation.

The results indicated that the serum creatinine (sCr) concentration at one month after transplantation was closely related to the concentration at 12 months. The recipients were divided into two groups based on the sCr concentration at one month after transplantation. Recipients with a sCr concentration greater than or equal to the median were classified into Group H, while those with concentrations that were less than the median were classified into Group L. A stepwise multiple regression analysis demonstrated that the salt intake in male recipients was an independent predictor of the renal function at 12 months (β = 0.663, p < 0.01), while the BMI was an independent factor in female recipients (β = 0.618, p < 0.01). Moreover, in female recipients, the BMI and serum uric acid values in Group H were significantly higher than those in Group L. The BMI values of the female recipients in Group H were significantly higher than those in Group L at all times during the follow-up period (p < 0.01).

In short, it is necessary to consider sex differences when investigating factors contributing to the renal function after kidney transplantation.


Article by Nao Kawabata, et al, from Japan.

Full access: http://mrw.so/4y7rUj

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