Weight Gain, Energy Intake, Energy Expenditure, and Immunosuppressive Therapy in Kidney Transplant Recipients

Abstract

Background: Weight gain after kidney transplantation is a common health problem. The factors in weight gain after kidney transplant include many factors such as age, ethnicity, gender, change in lifestyle (eg, kilocalorie intake and physical activity level), and immunosuppressive therapy. Research Questions: This study aimed to evaluate the relationship between weight gain and energy intake in dietary, energy expenditure in physical activity, and immunosuppressive therapy in kidney transplant recipients. Design: This prospective, observational study included 51 participants who underwent kidney transplant, during 6 months from the start of the study. Anthropometric measurements were performed at first week, third- and sixth-month follow-ups of transplant recipients. Participants also completed 3-day “Dietary Record Form” and the “Physical Activity Record Form” at each follow-up. Simple frequency, analysis of variance analysis, and correlation analysis were used for data analysis. Results: Weight gain in sixth month follow-up compared to baseline value was positively related to energy intake in first week (r = 0.59), third month (r = 0.75), and sixth month (r = 0.67) follow-ups, and energy expenditure in first week (r = 0.35) and sixth month (r = 0.34) follow-ups. However, weight gain was negatively related to mycophenolate mofetil dose (mg/d) in sixth month (r = −0.31) follow-up ( P < .05). Discussion: The results of this study provide an opportunity to reflect and discuss on modifiable risk factors such as energy intake and energy expenditure that affect weight gain posttransplantation in participants. It also examines the relationship between immunosuppressive therapy. Additionally, these results can be effective in designing interventions and managing risk factors to achieve weight management goals.

Effects of an individualized nutritional intervention on kidney function, body composition, and quality of life in kidney transplant recipients: Study protocol for a randomized clinical trial

“…The average weight gain after the first year of surgery is close to 5–10 kg or 5%–10% of the initial body weight [ 13 , 14 ]. Likewise, the body composition analysis shows a higher percentage of adiposity in relation to lean mass, which is associated with obesity and other factors [ 15 ], and may suggest a negative influence on kidney function, especially in the success of the graft [ 20 ].…”

“…Likewise, the body composition analysis shows a higher percentage of adiposity in relation to lean mass, which is associated with obesity and other factors [ 15 ], and may suggest a negative influence on kidney function, especially in the success of the graft [ 20 ]. In addition to immunosuppressive therapy, increased appetite, change in lifestyle and reduced dietary restrictions as well as reversal of uremia and limited physical activity contribute to this scenario [ 13 ].…”