| Theme | Reconsidering of Diet Therapy for Patients with Chronic Kidney Disease -- Is the clinical guideline for diet therapy edited by Japanese Society of Nephrology at 1997 valid? | |
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| Title | Nutritional management of renal transplant recipients | |
| Publish Date | 2006/12 | |
| Author | Yoko Kito | Department of Nutrition, Nagoya Daini Red Cross Hospital |
| Author | Norihiko Goto | Department of Surgery, Nagoya Daini Red Cross Hospital |
| Author | Kazuharu Uchida | Department of Surgery, Nagoya Daini Red Cross Hospital |
| Author | Kunio Morozumi | Department of Internal Medicine, Kidney Center, Nagoya Daini Red Cross Hospital |
| [ Summary ] | Nutritional management of renal transplant recipients is an important determinant of outcome in terms of both morbidity and mortality. Diet can be used to prevent and ameliorate many transplants related complications, although the precise nutrient requirements of kidney transplant recipients continue to be incompletely defined. A guideline to nutrition care management is necessary in the pretransplant, acute posttransplant, and long-term transplant periods. The primary nutritional focus in the pretransplant period is the prevention and treatment of malnutrition. The majority of dialysis patients have albumin levels equal to or less than 4.0 g / dl. During the acute postoperative period, adequate protein levels of 1.3 to 2.0 g / kg body weight and calorie levels of 35 kcal / kg are essential to counteract protein catabolism, and susceptibility to infection, as well as promoting healing. Chronic allograft nephropathy is a pivotal determinant of the long term outcome of graft functions. Many non-immunologic factors participate in the pathogenesis of chronic allograft nephropathy.Hypertension, hyperlipidemia, obesity, posttransplant diabetes mellitus and progression of renal disease play pivotal rolls in non-immunologic chronic allograft nephropathy and are causes of long term mortality. A daily protein intake of 1.0 g - 1.1 / kg has been recommended for stable posttransplant recipients with good renal functions. Lower protein levels may be appropriate for recipients with chronic allograft nephropathy. Caloric restriction should be combined with exercise and behavior modification. The propensity toward weight gain, and the potential contribution of lipids to decreased graft survival rates, and a reduced fat and cholesterol diet is appropriate for most long term recipients. |
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