title: Single-center assessment of nutritional counseling in preventing excessive weight gain in pediatric renal transplants recipients.
abstract: Post-transplantation obesity is a common complication that is associated with a higher risk for decreased allograft function and hypertension. However, the role of diet intervention on reducing post-transplantation obesity is relatively unknown. We investigated the clinical relevance of dietary counseling on the prevalence of overweight/obesity during the first two yr following renal transplantation. The computerized patient records of 42 recipients (31 males) aged 6.3 ± 4.8 yr at transplantation were reviewed. All patients systematically underwent yearly dietary assessment/counseling (motivational interviewing technique) and measurement of renal function and ABPM. At transplantation, 14.2% of patients were overweight/obese, which increased to 42.8% by two yr post-transplantation (p = 0.004). The majority of patients experienced a significant increase in BMI SDS during the first six months post-transplantation that remained sustained throughout the duration of the follow-up period (p = 0.001). By two yr post-transplantation, there were no observable differences between patients classified as having normal BMI or being overweight/obese with regard to renal function and controlled hypertension. The application of yearly tailored dietary assessment/counseling had a poor effect on preventing post-transplantation weight gain, suggesting the need for more comprehensive interventions to reduce post-transplant obesity.
authors.affiliation: Division of Pediatrics, Department for Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Camilla
authors.initials: C
authors.lastname: Cameron
authors.affiliation: Division of Pediatrics, Department for Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Rafael T
authors.initials: RT
authors.lastname: Krmar
mesh_terms: D064591:Allografts; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002648:Child; D053198:Child Nutrition Sciences / Q000379:methods*; D002675:Child, Preschool; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D062405:Motivational Interviewing; D009765:Obesity / Q000517:prevention & control; D050177:Overweight / Q000517:prevention & control; D010372:Pediatrics / Q000379:methods; D015995:Prevalence; D012016:Reference Values; D012189:Retrospective Studies; D066027:Transplant Recipients; D014180:Transplantation / Q000379:methods; D015430:Weight Gain
keywords: body mass index; children; hypertension; kidney transplantation; obesity