A Narrative Review of Dietary Approaches for Kidney Transplant Patients

Cyrino, Laura Goldfarb; Galpern, Jennie; Moore, Lori L.; Borgi, Lea; Riella, Leonardo V.

doi:10.1016/j.ekir.2021.04.009

Cited by 15 publications

(9 citation statements)

References 88 publications

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“…The role of nutrition and nutritional status in the pathogenesis of atherosclerosis and CV risk is receiving more and more attention in the general population [ 15 ] and in KTRs as well [ 16 , 17 ]. Patients with ESRD often suffer from protein energy wasting, malnutrition, and sarcopenia [ 18 ], and shortly after KTX, they face sudden weight gain and multiple metabolic changes, which puts an additional burden on this vulnerable population [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Number of Teeth and Nutritional Status Parameters Are Related to Intima-Media Thickness in Dalmatian Kidney Transplant Recipients

Novaković

Kojundžić

Radić

et al. 2022

JPM

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Although kidney transplantation significantly improves the quality of life of patients with end-stage renal disease (ESRD), the prevalence of cardiovascular disease (CVD) in kidney transplant recipients (KTRs) remains high. Atherosclerosis, post-transplantation metabolic changes, immunosuppressive therapy, and periodontitis contribute to elevated cardiovascular risk in this population. The aim of the study was to evaluate carotid intima-media thickness (IMT) as a surrogate marker of atherosclerosis and to analyze the possible risk factors for IMT in Dalmatian KTRs. Ninety-three KTRs were included in this study. Data on clinical and laboratory parameters, body composition, anthropometry, advanced glycation end-product (AGE) measurements, blood pressure, and arterial stiffness were collected. All participants underwent ultrasound examination of IMT and evaluation of periodontal status. KTRs with carotid IMT ≥ 0.9 were significantly older, had a lower level of total cholesterol, fat mass, end-diastolic velocity (EDV), and had fewer teeth. They also had significantly higher values of pulse wave velocity (PWV) and resistive index (RI). We found positive correlations between carotid IMT and duration of dialysis, age, PWV, AGE, RI, and average total clinical attachment level (CAL). The regression model showed that IMT in KTRs is associated with higher PWV, lower fat mass, and fewer teeth. The results of our study suggest that nutritional and periodontal status are associated with carotid IMT in KTRs.

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Section: Introductionmentioning

confidence: 99%

Number of Teeth and Nutritional Status Parameters Are Related to Intima-Media Thickness in Dalmatian Kidney Transplant Recipients

Novaković

Kojundžić

Radić

et al. 2022

JPM

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“…This study demonstrated the immunomodulatory capabilities of the gut microbiota in response to dietary interventions, therefore providing evidence in favor of combination therapies over strict pharmaceutical regimens for allograft maintenance ( 131 ). In fact, dietary modifications are known to have a modifying effect on the health of kidney transplant recipients ( 187 – 189 ). The Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets have been demonstrated to be the most beneficial dietary patterns for renal transplant recipients due to their emphasis on increasing fresh plant-based food intake as well as decreasing processed food and meat intake ( 187 ).…”

Section: Renal Transplantationmentioning

confidence: 99%

“…In fact, dietary modifications are known to have a modifying effect on the health of kidney transplant recipients ( 187 – 189 ). The Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets have been demonstrated to be the most beneficial dietary patterns for renal transplant recipients due to their emphasis on increasing fresh plant-based food intake as well as decreasing processed food and meat intake ( 187 ). For example, a recent single-center cohort-based clinical study involving 632 adult kidney transplant recipients reported in 2020 by Gomes-Neto and colleagues demonstrated the improved kidney function outcomes in renal transplant recipients following the Mediterranean diet plan ( 188 ).…”

Section: Renal Transplantationmentioning

confidence: 99%

The Impact of Human Microbiotas in Hematopoietic Stem Cell and Organ Transplantation

Sen

Thummer

2022

Front. Immunol.

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The human microbiota heavily influences most vital aspects of human physiology including organ transplantation outcomes and transplant rejection risk. A variety of organ transplantation scenarios such as lung and heart transplantation as well as hematopoietic stem cell transplantation is heavily influenced by the human microbiotas. The human microbiota refers to a rich, diverse, and complex ecosystem of bacteria, fungi, archaea, helminths, protozoans, parasites, and viruses. Research accumulating over the past decade has established the existence of complex cross-species, cross-kingdom interactions between the residents of the various human microbiotas and the human body. Since the gut microbiota is the densest, most popular, and most studied human microbiota, the impact of other human microbiotas such as the oral, lung, urinary, and genital microbiotas is often overshadowed. However, these microbiotas also provide critical and unique insights pertaining to transplantation success, rejection risk, and overall host health, across multiple different transplantation scenarios. Organ transplantation as well as the pre-, peri-, and post-transplant pharmacological regimens patients undergo is known to adversely impact the microbiotas, thereby increasing the risk of adverse patient outcomes. Over the past decade, holistic approaches to post-transplant patient care such as the administration of clinical and dietary interventions aiming at restoring deranged microbiota community structures have been gaining momentum. Examples of these include prebiotic and probiotic administration, fecal microbial transplantation, and bacteriophage-mediated multidrug-resistant bacterial decolonization. This review will discuss these perspectives and explore the role of different human microbiotas in the context of various transplantation scenarios.

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“…It focuses on planning meals rich in whole grains, vegetables, fruits, seeds, nuts, beans, legumes, and olive oil, with fish consumed on a twice-a-week basis. The predominance of unsaturated fats over saturated fats found in red meat reduces oxidative stress, chronic inflammation, and atherosclerosis [ 92 , 93 ]. Vučković et al explored the links between sticking to a Mediterranean diet, body composition, and depression symptoms and found an association between low muscle mass and depression symptoms [ 94 ].…”

Section: Dietary Patterns In the Ktx Populationmentioning

confidence: 99%

Nutrition Disturbances and Metabolic Complications in Kidney Transplant Recipients: Etiology, Methods of Assessment and Prevention—A Review

Górska

Kurnatowska

2022

Nutrients

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Nutrition disturbances occur at all stages of chronic kidney disease and progress with the decrease of the kidney filtration rate. Kidney transplantation (KTx) as the best form of kidney replacement therapy poses various nutritional challenges. Prior to transplantation, recipients often present with mild to advanced nutrition disturbances. A functioning allograft not only relieves uremia, acidosis, and electrolyte disturbances, but also resumes other kidney functions such as erythropoietin production and vitamin D3 metabolism. KTx recipients represent a whole spectrum of undernutrition and obesity. Since following transplantation, patients are relieved of most dietary restrictions and appetite disturbances; they resume old nutrition habits that result in weight gain. The immunosuppressive regimen often predisposes them to dyslipidemia, glucose intolerance, and hypertension. Moreover, most recipients present with chronic kidney graft disease at long-term follow-ups, usually in stages G2–G3T. Therefore, the nutritional status of KTx patients requires careful monitoring. Appropriate dietary and lifestyle habits prevent nutrition disturbances and may improve kidney graft function. Despite many nutritional guidelines and recommendations targeted at chronic kidney disease, there are few targeted at KTx recipients. We aimed to provide a brief review of nutrition disturbances and known nutritional recommendations for kidney transplant recipients based on the current literature and dietary trends.

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A Narrative Review of Dietary Approaches for Kidney Transplant Patients

Cited by 15 publications

References 88 publications

Number of Teeth and Nutritional Status Parameters Are Related to Intima-Media Thickness in Dalmatian Kidney Transplant Recipients

Number of Teeth and Nutritional Status Parameters Are Related to Intima-Media Thickness in Dalmatian Kidney Transplant Recipients

The Impact of Human Microbiotas in Hematopoietic Stem Cell and Organ Transplantation

Nutrition Disturbances and Metabolic Complications in Kidney Transplant Recipients: Etiology, Methods of Assessment and Prevention—A Review

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