Nutritional management of renal transplant patients

Transplantation is a major operation complicated by metabolic complications of pre-existing medical conditions and administration of immunosuppressive medications to prevent rejection. Even though the major causes of post-transplant metabolic abnormalities are not necessarily diet related, results from a number of studies have shown that these complications can be significantly improved through dietary intervention. An adequate nutritional status may improve outcomes after transplantation. Nutritional status is an important determinant of clinical outcome in patients with chronic renal disease. Post-transplant nutritional goals include providing adequate nutrients to treat catabolism and promote healing, monitoring and treating electrolyte abnormalities, and achieving optimal blood glucose control. The weight gain experienced by a large percentage of long-term renal recipients, is accompanied by a significant increase in body fat, which is partially explained by the immunosuppressive therapy and by a sedentary lifestyle. However, up to approximately 1 year after renal transplant, serum albumin levels may still be below normal, suggesting that protein malnutrition may persist after the transplant. A successful renal transplant allows greater dietary freedom and resultant weight gain. Dietary advice should be an important part of post-transplant treatment. This article reviews the effects of renal transplantation and the guidelines for nutritional management.