Dietary habits and nutritional status of renal transplant patients

Although dialysis nutritional problems are well described, nutritional problems after renal transplantation (RT) have received little attention.

Body composition as assessed by dual-energy x-ray absorptiometry in 115 stable patients 6.6 +/- 5.9 years after RT and repeated 2.9 years later, when a 3-day dietary history was obtained in 79 patients.

Patients diet was generally sufficient, but was characterized by a high fat intake and deficiencies in folic acid, vitamin D, thiamine, iodine, selenium, and iron intake. Patients were often overweight, and at any given weight had a 4% to 5% higher proportion of body fat than normal. Loss of fat weight was related to high initial fat weight, long RT duration, and low plasma bicarbonate, but not steroid dose.

Dietary advice concerning fat intake is indicated for RT patients, and nutritional supplements with folic acid and vitamin D are generally required. Their main nutritional problem is obesity. This is not adequately measured by body mass index, which should be supplemented by dual-energy x-ray absorptiometry. Attention should be paid to the prevention of acidosis.