Dietary protein intake and nutritional status in patients with renal transplant

BACKGROUND: Uremic patients on regular dialysis treatment (RDT) obtain and maintain with difficulty an adequate nutritional status. Successful kidney transplantation allows remarkable rehabilitation of patients with end-stage renal disease previously on RDT. However, information concerning the role of dietary protein restriction in the treatment of patients with chronic transplant rejection is scarce. PATIENTS AND METHODS: The role of dietary protein restriction in the treatment of patients with chronic transplant rejection was studied over 10 years in 42 patients with a kidney transplant to examine longterm renal and nutritional responses to dietary protein on graft renal function. In these patients, renal function was checked monthly, clinical evaluation and anthropometric measurements studied, nutritional status and all patients' diets were recorded. RESULTS: In 18 of these patients, biochemical signs of renal failure were found. A diet with 35 Kcal/kg and 0.7 - 0.8 grams of protein/Kg was instituted. Renal function studied every six months for 10 years showed improvement or stabilization. The low protein diet was associated with a significant reduction in 24-hour urinary protein excretion, without any change in blood pressure. Protein restriction was not associated with changes in serum protein. CONCLUSIONS: Our long-term study suggests that moderate protein intake may improve the course of chronic rejection and that restriction in protein intake may be a useful strategy in slowing the progression of renal disease in chronic rejection.