Outcome of Dietary Intervention on Kidney Transplant Recipients With Proteinuria/Chronic Metabolic Acidosis - A...

Proteinuria and chronic metabolic acidosis may negatively impact renal allograft survival. This study aims to evaluate dietary intervention in reducing proteinuria and correcting metabolic acidosis among kidney transplant recipients (KTRs).

This is a prospective dietary intervention study. KTRs who have proteinuria ≥ 0.5g/d or chronic metabolic acidosis with serum bicarbonate ≤ 22 mmol/L for at least two readings in the past 6 months were recruited. All recruited subjects were given one-to-one diet counseling for moderate dietary protein restriction at 0.8 g/kg of ideal body weight (IBW) and high vegetable and fruit intake by a research dietitian. All subjects were encouraged to replace animal protein with plant protein. The duration of the study was 3 months. Changes in proteinuria and serum bicarbonate levels pre- and postintervention were analyzed.

A total of 30 KTRs (26 with proteinuria and four with chronic metabolic acidosis) were enrolled and completed the intervention phase. Proteinuria reduced significantly after 1 month of the intervention (z = -2.643, P = .008) in alignment with a significant reduction in dietary protein (z = -2.376, P = .018) and dietary acid load (z = -2.149, P = .032). However, this effect was not sustainable when the dietary protein intake was increased at 3 months. Significant weight reduction was observed after 1 month (z = -3.379, P = .001) and 3 months (z = -3.503, P < .001) after dietary intervention. No statistically significant change in serum bicarbonate was found.

Dietary intervention can induce favorable dietary changes, leading to reductions in proteinuria and body weight in KTRs. Hence, dietary counseling should be part of the multiprong approach to managing KTRs.