Benefits of a dietary intervention on weight loss, body composition, and lipid profile after renal transplantation

Lopes, Iva Marques; Martin, Marisa; Errasti, P; Martínez, Jean

doi:10.1016/s0899-9007(98)00137-3

Cited by 58 publications

(37 citation statements)

References 11 publications

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“…Trans fats should also be avoided. Although benefits in lipid profile in RTR have been demonstrated in small studies (54,55), most transplant patients need drug therapy to reach lipid profile goals.…”

Section: Lifestyle Modification: Dietmentioning

confidence: 99%

Management of Cardiovascular Disease in Renal Transplant Recipients

Shirali¹,

Bia²

2008

Clinical Journal of the American Society of Nephrology

110

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Cardiovascular disease is a major cause of graft loss and the leading cause of death in renal transplant recipients. Although there are robust data on the frequency of risk factors and their contributions to cardiovascular disease in this population, few trials have demonstrated the benefit of modifying these risk factors to reduce cardiovascular events. Nevertheless, it is widely accepted that the clinical acumen filtered through the best available studies in the general population be used to treat individual renal transplant recipients given their high cardiovascular mortality. Transplant task forces and the Kidney Disease Outcomes Quality Initiative have created guidelines for this purpose. This review examines the data available for prevention and treatment of major risk factors contributing to cardiovascular disease in renal transplant recipients. The contribution of immunosuppressive agents to each risk factor and the evidence to support lifestyle modification as well as drug therapy are examined. Reducing cardiovascular risk factors requires an integrative approach that is best accomplished by a team of health care professionals. It creates a significant challenge but one that must be met if allograft survival is to improve.

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Section: Lifestyle Modification: Dietmentioning

confidence: 99%

Management of Cardiovascular Disease in Renal Transplant Recipients

Shirali¹,

Bia²

2008

Clinical Journal of the American Society of Nephrology

110

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“…As evidenced by many studies, undertaking dietary restrictions in an effort to lose weight before the date of transplant is rather ineffective and often unsuccessful. [65][66][67] In obese transplant candidates who lose weight via dietary restrictions, it was noted they were likely to gain that weight back after transplant; therefore, essentially undoing the benefits of weight loss before the surgical procedure. Posttransplant weight is gained primarily because of the improved metabolic conditions of the patient, resulting in increased nutrient absorption.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2016

Exp Clin Transplant

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Objectives: The prevalence of obesity is increasing rapidly and globally, yet systemic reviews on this topic are scarce. Our meta-analysis and systemic review aimed to assess how obesity affects 5 postoperative outcomes: biopsy-proven acute rejection, patient death, allograft loss, type 2 diabetes mellitus after transplant, and delayed graft function. Materials and Methods: We evaluated peer-reviewed literature from 22 medical databases. Studies were included if they were conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology criteria, only examined postoperative outcomes in adult patients, only examined the relation between recipient obesity at time of transplant and our 5 postoperative outcomes, and had a minimum score of > 5 stars on the Newcastle-Ottawa scale for nonrandomized studies. Reliable conclusions were ensured by having our studies examined against 2 internationally known scoring systems. Obesity was defined in accordance with the World Health Organization as having a body mass index of > 30 kg/m 2 . All obese recipients were compared versus "healthy" recipients (body mass index of 18.5-24.9 kg/m 2 ). Hazard ratios were calculated for biopsy-proven acute rejection, patient death, allograft loss, and type 2 diabetes mellitus after transplant. An odds ratio was calculated for delayed graft function. Results: We assessed 21 retrospective observational studies in our meta-analysis (N = 241 381 patients). In obese transplant recipients, hazard ratios were 1.51 (95% confidence interval, 1.24-1.78) for presence of biopsy-proven acute rejection, 1.19 (95% confidence interval, 1.10-1.31) for patient death, 1.54 (95% confidence interval, 1.38-1.68) for allograft loss, and 1.01 (95% confidence interval, 0.98-1.07) for development of type 2 diabetes mellitus. The odds ratio for delayed graft function was 1.81 (95% confidence interval, 1.51-2.13). Conclusions: Our meta-analysis clearly demonstrated greater risks for obese renal transplant recipients and poorer postoperative outcomes with obesity. We confidently recommend renal transplant candidates seek medically supervised weight loss before transplant.

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“…A nutritionist should be involved in management. Small, uncontrolled trials in KTRs suggest that diet and other behavior modifications are safe and help reduce weight over the short term (40,41). There is no evidence that any one diet is more effective than any other.…”

Section: Obesitymentioning

confidence: 99%