Nutritional intakes in Italian kidney transplant recipients

Abstract

Background and Aim: Obesity, dyslipidemia, hypertension and glucose intolerance are some of the main nutritional and metabolic problems that occur in post-transplant patients. We evaluated the daily dietary intake in renal transplant recipients to assess whether they fulfil the nutrient intake recommendations (according to the Italian recommended dietary allowances, LARN 2014). Subjects and Methods: Renal allograft recipients that were transplanted between 6 months and 5 years before this study were recruited. The daily intake of nutrients, including protein and salt, was estimated with a five-day food diary. Results: In total, 50 patients were studied (31 males and19 females); the mean patients’ age was 48.9±9.9 years, the mean age at transplant was 20.5±15.2 years (median 15.3 y) and the mean eGFR was 56.4±20.2 mL/min/1.73m2, with the eGFR terziles defined as >66.7, between 44.6 and 66.7, and <44.6 mL/min/1.73m2. The mean body mass index was 26.7±4.4 kg/m2. The medium total energy intake was 27.6±7.6 kcal/kg body weight/day. The daily intake of proteins and salt were respectively 1.06±0.32 g/kg body weight/day and 1.203 mg/day. The calcium, iron and fiber intakes were respectively 484±236 mg/die, 9.6±2.9 mg/die, and 12.2±4.9 g/die. No differences in nutrients intake were observed between patients with different degree of renal insufficiency; also, protein intake was above the threshold of 1.0 g/kgBW/day in all patients. Discussion: Our findings suggest that renal transplant recipients in Italy seem to have an adequate energy intake, with normal distributions of proteins, lipids and carbohydrates; the protein intake, however, was higher than that recommended for chronic kidney disease (CKD), at least for moderate to advanced CKD. On the contrary, the daily intake of fiber, calcium and iron were insufficient. Finally, the salt intake was greater than the recommendation in almost all individuals. Conclusions: In renal transplant patients the mean dietary intakes fit with the recommendations, though this is not true for all the patients studied especially regarding the salt and protein intakes in the moderate to advance CKD stages. This observation suggests the need of a specific nutritional counselling and a regular nutritional assessment in patients with renal transplantation.