title: Nutritional consequences of renal transplantation.
abstract: Successful kidney transplantation leads to restoration of renal function. Some metabolic disorders from chronic renal failure may persist and new metabolic abnormalities can develop (obesity, diabetes, hypertension, bone disease, and anemia). Additionally, influence of immunosuppressive drugs (corticosteroids, cyclosporine A, tacrolimus, and rapamycin) may aggravate the course of diabetes, hypertension, and dyslipidemia. Nutritional management of renal transplantation is divided into the pretransplant period, transplant surgery, and early and late posttransplant period. Patients in the pretransplant period in dialysis treatment may develop protein-energy malnutrition and negative nitrogen balance, with loss of lean body mass and fat deposits. Nutritional management in the early posttransplant period with a functioning kidney graft necessitates fluid and electrolyte balance control with protein intake of 1,2/kg BW/day and 30-35 kcal/kg BW/day. In a nonfunctioning kidney graft, dialysis treatment continues and the therapeutic dose of immunosuppressive drugs must be reduced. The principal objective in the late posttransplant period is the maintenance of optimal nutritional status. Nutrition is important in managing obesity, insulin resistance, diabetes, hyperlipidemia, and hypertension. Other posttransplant conditions for which diet and/or nutritional supplements may be beneficial include hypomagnesemia, hypophosphatemia, hyperuricemia, hyperkalemia, hyperhomocysteinemia, chronic renal allograft failure, renal anemia, and renal bone disease.
authors.affiliation: Department of Nephrology, Transplant Centre, Institute for Clinical and Experimental Medicine and Institute for Postgraduate Education, Prague, Czech Republic. vladimir.teplan@ikem.cz
authors.forename: Vladimir
authors.initials: V
authors.lastname: Teplan
authors.forename: Ivo
authors.initials: I
authors.lastname: Valkovsky
authors.forename: Vladimir
authors.initials: V
authors.lastname: Teplan
authors.forename: Milena
authors.initials: M
authors.lastname: Stollova
authors.forename: Frantisek
authors.initials: F
authors.lastname: Vyhnanek
authors.forename: Michal
authors.initials: M
authors.lastname: Andel
mesh_terms: D001823:Body Composition / Q000502:physiology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D009751:Nutritional Requirements; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000453:epidemiology / Q000209:etiology; D014882:Water-Electrolyte Balance / Q000502:physiology
chemical_list: D007166:Immunosuppressive Agents