Advertisement

What is Known About Dietary Interventions and Body Weight Management After Kidney Transplantation? A Scoping Review

  • Elis Forcellini Pedrollo
    Correspondence
    Address correspondence to Elis Forcellini Pedrollo, PhD, Dona Laura Street 333, 401/ 90430091 Porto Alegre, Rio Grande do Sul, Brazil.
    Affiliations
    Post Graduate Program in Health Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
    Search for articles by this author
  • Camila Corrêa
    Affiliations
    Post Graduate Program in Health Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
    Search for articles by this author
  • Bruna Bellincanta Nicoletto
    Affiliations
    Post Graduate Program in Health Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Knowledge Area of Life Sciences, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
    Search for articles by this author
  • Gabriela Corrêa Souza
    Affiliations
    Department of Nutrition and Post Graduate Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Food and Nutrition Research Center, Hospital de Clínicas de Porto Alegre (HCPA-UFRGS), Porto Alegre, Brazil
    Search for articles by this author
  • Cristiane Bauermann Leitão
    Affiliations
    Post Graduate Program in Health Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
    Search for articles by this author

      Objective

      Several studies report weight gain after kidney transplantation, which is commonly related to poor outcomes. However, recommendations for dietary interventions aiming to manage these patients’ weight are still scarce in the literature. Thus, this review seeks to describe the state of literature on the effect of dietary interventions on weight after kidney transplantation.

      Design

      Scoping review.

      Methods

      This review was designed according to the recommendations for scoping reviews elaborated by the Joanna Briggs Institute. Studies assessing the effect of dietary interventions on body weight after kidney transplantations were searched in MEDLINE, EMBASE, and Clinicaltrials.gov databases up to June 28, 2021. Two independent reviewers summarized the data collected.

      Results

      Thirteen (503 patients) of the 4.983 articles identified in the searched databases were included in our study. Most studies were published before 2010 and presented incomplete methodology descriptions. Nutritional counseling and dietary prescriptions according to the Step 1 diet of the American Heart Association (AHA) were the most common interventions. Only 2 studies evaluated changes in body weight as primary outcome. Three studies were randomized clinical trials (RCT), and none of these found the adopted interventions to demonstrate benefits.

      Conclusion

      Our scoping review evinced a scarcity of data available in the literature addressing this topic. Most studies were not controlled and presented poor methodological quality. Moreover, these studies included small sample sizes, so that the assessment of dietary interventions in these patients still lacks power for definitive conclusions. Prospective RCT should be conducted to define effective in preventing weight gain or weight loss after kidney transplant.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Renal Nutrition
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Haller M.
        • Gutjahr G.
        • Kramar R.
        • Harnoncourt F.
        • Oberbauer R.
        Cost-effectiveness analysis of renal replacement therapy in Austria.
        Nephrol Dial Transpl. 2011; 26: 2988-2995
        • Wolfe R.A.
        • Ashby V.B.
        • Milford E.L.
        • et al.
        Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant.
        N Engl J Med. 1999; 341: 1725-1730
        • Cosio F.G.
        • Pesavento T.E.
        • Kim S.
        • Osei K.
        • Henry M.
        • Ferguson R.M.
        Patient survival after renal transplantation: IV. Impact of post-transplant diabetes.
        Kidney Int. 2002; 62: 1440-1446
        • Jardine A.G.
        • Gaston R.S.
        • Fellstrom B.C.
        • Holdaas H.
        Prevention of cardiovascular disease in adult recipients of kidney transplants.
        Lancet. 2011; 378: 1419
        • Hill C.J.
        • Courtney A.E.
        • Cardwell C.R.
        • et al.
        Recipient obesity and outcomes after kidney transplantation: a systematic review and meta-analysis.
        Nephrol Dial Transpl. 2015; 30: 1403-1411
        • Nicoletto B.B.
        • Souza G.C.
        • Goncalves L.F.
        • Costa C.
        • Perry I.S.
        • Manfro R.C.
        Leptin, insulin resistance, and metabolic changes 5 years after renal transplantation.
        J Ren Nutr. 2012; 22: 440-449
        • Nicoletto B.B.
        • Fonseca N.K.
        • Manfro R.C.
        • Gonçalves L.F.
        • Leitão C.B.
        • Souza G.C.
        Effects of obesity on kidney transplantation outcomes: a systematic review and meta-analysis.
        Transplantation. 2014; 98: 167-176
        • Pedrollo E.F.
        • Correa C.
        • Nicoletto B.B.
        • et al.
        Effects of metabolic syndrome on kidney transplantation outcomes: a systematic review and meta-analysis.
        Transpl Int. 2016; 29: 1059-1066
        • Sabbatini M.
        • Ferreri L.
        • Pisani A.
        • et al.
        Nutritional management in renal transplant recipients: a transplant team opportunity to improve graft survival.
        Nutr Metab Cardiovasc Dis. 2019; 29: 319-324
        • Cochran C.C.
        • Kent P.S.
        Nutrition management of the adult renal transplant patient.
        in: Stover J. Wiesen K. Byham-Gray L. A clinical guide to nutrition care in kidney disease. Renal Dietitians Dietetic Practice Group of the American Dietetic Association and the Council on Renal Nutrition of the. National Kidney Foundation, 2013: 71e85
        • Chadban S.
        • Chan M.
        • Fry K.
        • et al.
        • CARI
        The CARI guidelines. Protein requirement in adult kidney transplant recipients.
        Nephrology. 2010; 15: S68e71
        • Nazemian F.
        • Naghibi M.
        Weight-gain-related factors in renal transplantation.
        Exp Clin Transpl. 2005; 3: 329-332
        • Clunk J.M.
        • Lin C.Y.
        • Curtis J.J.
        Variables affecting weight gain in renal transplant recipients.
        Am J Kidney Dis. 2001; 38: 349-353
        • Pirsch J.D.
        Weight gain after kidney transplantation: weight too much.
        Transplantation. 2008; 85: 1387-1388
        • Kasiske B.L.
        • Sneyder J.J.
        • Gilbertson D.
        • Matas A.J.
        Diabetes mellitus after kidney transplantation in the United States.
        Am J Transpl. 2003; 3: 178-185
        • Henggeler C.K.
        • Plank L.D.
        • Ryan K.J.
        • et al.
        A randomized controlled trial of an intensive nutrition intervention versus standard nutrition care to avoid excess weight gain after kidney transplantation: the INTENT trial.
        J Ren Nutr. 2018; 28: 340-351
        • Guida B.
        • Trio R.
        • Laccetti R.
        • et al.
        Role of dietary intervention on metabolic abnormalities and nutritional status after renal transplantation.
        Nephrol Dial Transpl. 2007; 22: 3304e10
        • Patel M.G.
        The effect of dietary intervention on weight gains after renal transplantation.
        J Ren Nutr. 1998; 8: 137-141
      1. The Joanna Briggs Institute reviewers' Manual 2015 methodology for JBI scoping reviews. The Joanna Briggs Inst.
        • Arskey H.
        • O'Malley L.
        Scoping studies: towards a methodological framework.
        Int J Soc Res Methodol. 2005; 8: 19-23
        • Orazio L.K.
        • Isbel N.M.
        • Armstrong K.A.
        • et al.
        Evaluation of dietetic advice for modification of cardiovascular disease risk factors in renal transplant recipients.
        J Ren Nutr. 2011; 21: 462-471
        • Salahudeen A.K.
        • Hostetter T.H.
        • Raatz S.K.
        • Rosenberg M.E.
        Effects of dietary protein in patients with chronic renal transplant rejection.
        Kidney Int. 1992; 41: 183-190
        • Apicella L.
        • Guida B.
        • Vitale S.
        • et al.
        Short-term effects of an Ω-3 rich diet on metabolic and inflammatory markers in renal transplant recipients.
        NDT. 2012; 27
        • Bernardi A.
        • Biasia F.
        • Pati T.
        • Piva M.
        • D'Angelo A.
        • Bucciante G.
        Long-term protein intake control in kidney transplant recipients: effect in kidney graft function in nutritional status.
        Am J Kidney Dis. 2003; 41: S146-S152
        • Chadban S.
        • Clayton P.
        • Whitman G.
        • et al.
        A prospective trial of diet and exercise to improve glucose metabolism and cardiovascular risk for de novo kidney transplant recipients treated with tacrolimus-bases immunosuppression (An Interim analysis).
        Supplement Transplant. 2010; 90
        • Cupisti A.
        • Ghiadoni L.
        • DÁlessandro C.
        • et al.
        Soy protein diet improves endothelial dysfunction in renal transplant patients.
        Nephrol Dial Transpl. 2007; 22: 229-234
        • Hines L.
        Can low-fat/cholesterol nutrition counseling improve food intake habits and hyperlipidemia of renal transplant patients?.
        J Ren Nutr. 2000; 1: 30-35
        • Lopes I.M.
        • Martin M.
        • Errasti P.
        • Martínez J.A.
        Benefits of a dietary intervention on weight loss, body composition, and lipid profile after renal transplantation.
        Nutrition. 1999; 15: 7-10
        • Moore R.A.
        • Callahan M.F.
        • Cody M.
        • et al.
        The effect of the American Heart Association step one diet on hyperlipidemia following renal transplantation.
        Transplantation. 1990; 49: 60-62
        • Sapan M.
        • Ozben B.
        • Yakupoglu G.
        • Suleymanlar G.
        • Ozben T.
        Effects of diet and gemfibrozil on posttransplant hyperlipidemia in renal transplant recipients.
        J Investig Med. 2009; 57: 456-459
        • The Expert Panel
        Report of the National Cholesterol Education Program Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults.
        Arch Intern Med. 1988; 148: 136
        • Strejec J.
        Nutrition guidelines after kidney transplantation.
        J Ren Nutr. 2000; 10: 161-167
        • Dansinger M.L.
        • Tatsioni A.
        • Wong J.B.
        • Chung M.
        • Balk E.M.
        Meta-analysis: the effect of dietary counseling for weight loss.
        Ann Intern Med. 2007; 147: 41-50
        • Curioni C.
        • Lourenco P.
        Long-term weight loss after diet and exercise: a systematic review.
        Int J Obes. 2005; 29: 1168-1174
        • Belza A.
        • Ritz C.
        • Sørensen M.Q.
        • Holst J.J.
        • Rehfeld J.F.
        • Astrup A.
        Contribution of gastroenteropancreatic appetite hormones to protein-induced satiety.
        Am J Clinnutr. 2013; 97: 980-989
        • Larsen T.M.
        • Dalskov S.M.
        • van Baak M.
        • et al.
        Diets with high or low protein content and glycemic index for weight-loss maintenance.
        N Engl J Med. 2010; 363: 2102-2113
        • Astrup A.
        • Geiker N.R.
        Efficacy of higher protein diets for long-term weight control. How to assess quality of randomized controlled trials?.
        Nutr Metab Cardiovasc Dis. 2014; 24: 220-223
        • Fouque D.
        • Laville M.
        • Boissel J.P.
        Low protein diets for chronic kidney disease in non diabetic adults.
        Cochrane Database Syst Rev. 2006; 2: CD001892
        • Brenner M.J.
        • Meyer T.W.
        • Hostetter T.H.
        Dietary Protein Intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease.
        N Engl J Med. 1982; 307: 652-659
        • Metges C.C.
        • Barth C.A.
        Metabolic Consequences of a high dietary-protein intake in adulthood: assessment of the available evidence.
        J Nutr. 2000; 130: 886-889
        • Said M.Y.
        • Deetman P.E.
        • de Vries A.P.J.
        • et al.
        Causal path analyses of the association of protein intake with risk of mortality and graft failure in renal transplant recipients.
        Clin Transpl. 2015; 29: 447-457
        • Zoccali C.
        • Mallamaci F.
        Moderator's view: low-protein diet in chronic kidney disease: effectiveness, efficacy and precision nutritional treatments in nephrology.
        Nephrol Dial Transpl. 2018; 33: 287e91
        • Klaassen G.
        • Zelle D.M.
        • Navis G.J.
        • et al.
        Lifestyle intervention to improve quality of life and prevent weight gain after renal transplantation: design of the Active Care after Transplantation (ACT) randomized controlled trial.
        BMC Nephrol. 2017; 18: 296
        • Pedrollo E.F.
        • Nicoletto B.B.
        • Carpes L.S.
        • et al.
        Effect of an intensive nutrition intervention of a high protein and low glycemic-index diet on weight of kidney transplant recipients: study protocol for a randomized clinical trial.
        Trials. 2017; 18: 413
        • Sabbatini M.
        • Garofalo G.
        • Borrelli S.
        • et al.
        Efficacy of a reduced pill burden on therapeutic adherence to calcineurin inhibitors in renal transplant recipients: an observational study.
        PatientPreferAdherence. 2014; 8: 73e81
        • Ichimaru N.
        • Nakazawa S.
        • Yamanaka K.
        • et al.
        Adherence to dietary recommendations in maintenance phase kidney transplant patients.
        Transpl Proc. 2016; 48: 890.e2
        • Cianciaruso B.
        • Pota A.
        • Pisani A.
        • et al.
        Metabolic effects of two low protein diets in chronic kidney disease stage 4-5–a randomized controlled trial.
        Nephrol Dial Transpl. 2008; 23: 636e44
        • Notaras S.
        Conti JA qualitative analysis of eating behaviour change for patients with diabetes and non-dialysis dependent chronic kidney disease stages 4-5.
        J Rencare. 2018; 44: 219-228
        • Spahn J.M.
        • Reeves R.S.
        • Keim K.S.
        • et al.
        State of the evidence regarding behavior change theories and strategies in nutrition counseling to facilitate health and food behavior change.
        J Am Diet Assoc. 2010; 110: 879-891
        • Peters M.D.
        • Godfrey C.M.
        • Khalil H.
        • McInerney P.
        • Parker D.
        • Soares C.B.
        Guidance for conducting systematic scoping reviews.
        Int J Evid Based Health. 2015; 13: 141-146