Nutrition in Kidney Transplantation

Veroux, Massimiliano; Corona, Daniela; Sinagra, N.; Tallarita, Tiziano; Ekser, Burçin; Giaquinta, Alessia; Zerbo, D.; Veroux, Pierfrancesco

doi:10.5301/ijao.5000234

Cited by 13 publications

(19 citation statements)

References 80 publications

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“…Malnutrition at this time is associated with impaired surgical wound healing and higher risk of infection. 30,31 About 85% of the patients from G1 received kidney from living donor compared with 46% and 36% of the patients from G2 and G3, respectively. Thus, patients from G1 had less time on hemodialysis and were transplanted younger than patients from G2 and G3, thereby reducing the risk of becoming malnourished.…”

Section: Discussionmentioning

confidence: 99%

Pretransplant Malnutrition Risk Score: A Simple and Useful Tool for Predicting Kidney Transplant Outcomes

Santos¹,

Nascimento²,

Lasmar³

et al. 2020

Preprint

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Background: The prevalence of malnourished patients before transplantation and the influence of malnutrition on graft and patient outcomes remain underestimated, despite being associated with higher postoperative morbidity and mortality. This study aimed to develop an easy nutritional screening tool and evaluate the impact of the nutritional status on clinical outcome, graft survival and mortality risk in kidney transplant (KT) patients.Methods: In this retrospective cohort study including 451 KT patients, we developed a score by using anthropometric, clinical, and laboratory measures performed in the pretransplant evaluation. The sum of all its components ranged from 0 to 12 points. The patients were stratified into 3 groups: G1 (0 or 1 point)=low risk, G2 (2 to 4 points)=moderate risk, and G3 (>5 points)=high risk of malnutrition. Results: Stratifying the patients, G1, G2, and G3 were composed of 90, 292, and 69 patients, respectively. Patients from G1 maintained the lowest serum creatinine levels at hospital discharge when compared with others (p=0.012). The incidence of infection in the patients from G3 had was higher than patients from G1 and G2 (p=0.030). G3 recipients showed worse GS than G1 patients (p=0.044). G3 patients showed almost threefold higher risk for graft loss (HR 2.94, 95% CI 1.084-7.996). Conclusions: KT patients with higher malnutrition risk score was associated with worse outcomes and graft survival. The nutritional screening tool is easy to be used in clinical practice to evaluate the patient in preparation for KT.

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Section: Discussionmentioning

confidence: 99%

Pretransplant Malnutrition Risk Score: A Simple and Useful Tool for Predicting Kidney Transplant Outcomes

Santos¹,

Nascimento²,

Lasmar³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…In addition, nutritional status is positively associated with successful transplantation and survival in patients. Therefore, maintenance of optimal nutritional status, including body composition, should be ensured in all patients with end-stage renal disease[ 16 , 17 ].…”

Section: Nutritional Therapy Before Renal Transplantationmentioning

confidence: 99%

“…The side effects of immunosuppression in the late period after transplantation are increased bodyweight, which can be explained by sedentary lifestyle, food intake, and appetite. In post transplantation nutrition therapy, it should be aimed to balance electrolyte changes and to minimize the risk of osteoporosis and cardiovascular disease[ 16 ]. The COVID-19 pandemic has brought some concerns and changes in the nutritional treatments of renal transplantation patients, who are a risky group.…”

Section: Nutritional Therapy After Renal Transplantationmentioning

confidence: 99%

Medical nutritional therapy for renal transplantation in the COVID-19 pandemic

Akbulut

Gencer-Bingol

2021

WJT

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Nutritional therapy is very important at renal transplantation. Nutrition has become more vital for transplantation patients owing to the coronavirus disease 2019 (COVID-19) pandemic. Inadequate nutrition can negatively affect the immune system. For this reason, adequate protein and energy intake should be provided to the patients. Also, overconsumption of saturated fat, sugar, and refined carbohydrates can both negatively affect the immune system and trigger chronic diseases in transplantation patients. In addition, vitamins and minerals should be monitored and inadequacy should be prevented due to immunomodulatory effects. Applying nutritional therapy suitable for the symptoms of renal transplantation patients and preventing comorbidities may reduce the risk and severity of COVID-19 infection.

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“…Nutrition is increasingly acknowledged as a modifiable factor to improve prospects in KTR [ 5 ]. Many factors, such as dietary restrictions, stress, medication use, and comorbidities, pose a challenge to maintain adequate nutrition after renal transplantation [ 5 , 6 , 7 , 8 , 9 , 10 ], while adequate nutrition has been implicated to prevent clinical conditions that adversely affect long-term outcome and premature mortality in KTR [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Urinary Excretion of N1-Methylnicotinamide and N1-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients

et al. 2020

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It is unclear whether niacin nutritional status is a target for improvement of long-term outcome after renal transplantation. The 24-h urinary excretion of N1-methylnicotinamide (N1-MN), as a biomarker of niacin status, has previously been shown to be negatively associated with premature mortality in kidney transplant recipients (KTR). However, recent evidence implies higher enzymatic conversion of N1-MN to N1-methyl-2-pyridone-5-carboxamide (2Py) in KTR, therefore the need exists for interpretation of both N1-MN and 2Py excretion for niacin status assessment. We assessed niacin status by means of the 24-h urinary excretion of the sum of N1-MN and 2Py (N1-MN + 2Py), and its associations with risk of premature mortality in KTR. N1-MN + 2Py excretion was measured in a longitudinal cohort of 660 KTR with LS-MS/MS. Prospective associations of N1-MN + 2Py excretion were investigated with Cox regression analyses. Median N1-MN + 2Py excretion was 198.3 (155.9–269.4) µmol/day. During follow-up of 5.4 (4.7–6.1) years, 143 KTR died, of whom 40 due to an infectious disease. N1-MN + 2Py excretion was negatively associated with risk of all-cause mortality (HR 0.61; 95% CI 0.47–0.79; p < 0.001), and infectious mortality specifically (HR 0.47; 95% CI 0.29–0.75; p = 0.002), independent of potential confounders. Secondary analyses showed effect modification of hs-CRP on the negative prospective association of N1-MN + 2Py excretion, and sensitivity analyses showed negative and independent associations of N1-MN and 2Py excretion with risk of all-cause mortality separately. These findings add further evidence to niacin status as a target for nutritional strategies for improvement of long-term outcome in KTR.

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Nutrition in Kidney Transplantation

Cited by 13 publications

References 80 publications

Pretransplant Malnutrition Risk Score: A Simple and Useful Tool for Predicting Kidney Transplant Outcomes

Pretransplant Malnutrition Risk Score: A Simple and Useful Tool for Predicting Kidney Transplant Outcomes

Medical nutritional therapy for renal transplantation in the COVID-19 pandemic

Urinary Excretion of N1-Methylnicotinamide and N1-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients

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