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Dietary Intake of Calories and Protein in the Acute Phase Following Kidney Transplant: Opportunities for Improvement

L. Teigen1, G. Onyeaghala1, Y. Doronin2, B. Guo1, B. Wu1, J. Abrahante1, D. Schladt1, W. Guan1, C. Staley1, M. Al-Kofahi1, S. Riad1, A. Matas1, R. Remmel1, W. Oetting1, C. Dorr1, P. Jacobson1, A. Israni1

1University of Minnesota, Minneapolis, MN, 2Hennepin Healthcare Research Institute, Minneapolis, MN

Meeting: 2021 American Transplant Congress

Abstract number: 909

Keywords: Enteral nutrition, Kidney transplantation, Metabolic complications, Morbidity

Topic: Clinical Science » Kidney » Kidney: Cardiovascular and Metabolic Complications

Session Information

Session Name: Kidney: Cardiovascular and Metabolic Complications

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Nutritional therapy post kidney transplant includes both an acute (1-1.5 months post-transplant) and a chronic phase. To date, most of the available literature has focused on the metabolic derangements (e.g. obesity, diabetes) associated with the chronic phase. Adequate nutrition during the acute phase, however, is essential to support an increased metabolic demand following surgery and to begin correction of altered body composition (e.g. sarcopenia) associated with end stage renal disease, which is important for long-term metabolic health. Currently, recommendations support calorie intakes of up to 35 kcal/kg/d and protein intakes of up to 1.5 g/kg/d, but little is known about dietary intake during the acute post transplantation phase.

*Methods: In the Microbiome and Immunosuppression in Kidney Transplantation (MISSION) study, we collected baseline 48 hours food recalls up to 20 days after kidney transplantation for 7 participants, using the Nutrition Data System for Research (NDSR). Descriptive tables and figures were generated using SAS version 9.4.

*Results: Demographic characteristics, calorie, and protein intake of the study cohort are presented in Table 1. Calorie and protein intake collected during the 3 weeks post-transplant correlated positively (r=0.84). Calorie intake ranged from 20 kcal/kg/d to 34 kcal/kg/d and protein intake ranged from 0.7 g/kg/d to 1.5 g/kg/d. Only 1/7 (14%) kidney transplant recipients achieved a calorie intake of ~35 kcal/kg/d. Similarly, only 1/7 (14%) patients achieved a protein intake of 1.5 g/kg/d. Notably, 4/7 (57%) patients had protein intakes less than 1.0 g/kg/d.

*Conclusions: These preliminary findings suggest an opportunity to optimize nutritional intake in the acute period following kidney transplantation. Given the negative impact of end stage renal disease on body composition, it is important to ensure adequate nutritional intake begins in the acute post-transplantation phase to help support both recovery from surgery and prevention of long-term metabolic complications.

Table 1: Demographics and Dietary Intake
Variable
Body Mass Index (BMI; kg/m2); Median (Min, Max) 27.3 (23.3, 27.8)
Sex (Female:Male) 3:4
Donor Type (Living:Deceased) 4:3
Calorie Intake (kcal/kg/d); Median (Min, Max) 22.4 (19.8, 34.3)
Protein Intake (g/kg/d); Median (Min, Max) 0.8 (0.7, 1.5)
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To cite this abstract in AMA style:

Teigen L, Onyeaghala G, Doronin Y, Guo B, Wu B, Abrahante J, Schladt D, Guan W, Staley C, Al-Kofahi M, Riad S, Matas A, Remmel R, Oetting W, Dorr C, Jacobson P, Israni A. Dietary Intake of Calories and Protein in the Acute Phase Following Kidney Transplant: Opportunities for Improvement [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/dietary-intake-of-calories-and-protein-in-the-acute-phase-following-kidney-transplant-opportunities-for-improvement/. Accessed May 16, 2025.

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