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A7. A survey of current dietary recommendations for post-transplant renal patients in the UK and Ireland

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Abstract:

Background

In recent years there has been a rise in medical knowledge and scientific information in the area of nutritional disorders and nutritional treatment in patients with renal disease and those with acute or chronic renal failure. Aim

To establish the current dietary management of renal transplant patients in the United Kingdom (UK) and Ireland. Methods

A total of 47 renal transplant units were identified in the UK and Ireland and a postal questionnaire was sent to each of these units. Results

Thirty-three units replied giving a 70% response rate: Only one did not have a dietitian to advise transplant recipients on their diet. In the majority of units energy requirements of early and late post-transplant patients were calculated using 30–35┬ákcal/kg/day or using the Schofield equations. 42% of units gave early post-transplant weight loss advice for the overweight patient but 88% of units gave late post-transplant weight loss advice. 52% or units at both early and late transplant stages gave advice on weight gain for underweight or malnourished patients.

50% of total energy intake from carbohydrate was frequently recommended in early and late post-transplant, with restriction of simple sugars as required. A fat intake early post-transplant of 30% of total energy intake was prescribed by the majority of respondents with a fat intake of less than 30% of total energy intake during late post-transplant stage to control for hyperlipidaemia, improved graft outcome and to encourage healthier eating. 18% of transplant units reported that vitamins and minerals would be supplemented early and late post-transplant, if the patient had a poor appetite, inadequate diet or if nutrient deficient. Conclusions

The dietary prescriptions were similar except for some variation in protein and electrolyte prescriptions. The findings from this study indicate that a policy on dietary management for post-transplant patients could be developed with respect to Carbohydrate, Fat and Energy prescription. Protein and electrolytes should continue to be calculated on an individual basis by a renal transplant unit dietitian. It was noted that dietitians adapted their recommendations for individual care in relation to changes in nutritional and biochemical status.

This study also highlighted the need for further research to be conducted on optimal protein and micronutrient prescriptions with respect to immunosuppressive drug interactions and graft survival.

Document Type: Abstract

Publication date: October 1, 2000

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