Nutritional status, energy expenditure, and protein oxidative stress after kidney transplantation

ABSTRACT

Objectives: To evaluate the association between nutritional status, resting energy expenditure (REE), and protein oxidative stress in patients after kidney transplantation (KT).

Methodology: The study evaluated 35 patients transplanted at the time of hospital discharge and 3 months after regarding: body composition, REE (by indirect calorimetry), and injury factor (IF); serum urea, creatinine, glucose, albumin, total protein, advanced oxidation protein products (AOPP), vitamin C.

Results: Three months after discharge, there was an improvement in renal function, nutritional status, and oxidative stress, with a standardization in the REE/kg. There was an increase in body weight, mainly in fat mass. The correlations showed that a greater cold ischemia time resulted in a deeper decline in vitamin C; a longer hospital length stay resulted in a greater reduction in AOPP; the higher preoperative body weight showed greater increases in body fat and glucose after transplantation. For decreases in REE and IF, there were increases in total protein. Finally, at hospital discharge there was a greater gain in weight, lower albumin, and total protein among individuals who had rejection episodes.

Discussion: The KT improves many of metabolic abnormalities, with the improvement of nutritional status, oxidative stress, and normalization of REE.

KEYWORDS:

• Kidney transplantation
• protein oxidative stress
• nutritional status
• energy expenditure
• body composition

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Larissa Vieira Marino obtained bachelor’s degree in nutrition and metabolism and master’s degree in clinic nutrition at Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.

Elen Almeida Romão is a professor doctor at the Department of Internal Medicine, Division of Nephrology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.

Paula Garcia Chiarello is a professor doctor in clinic nutrition at the Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.

ORCID

Larissa Vieira Marino http://orcid.org/0000-0002-0137-2864

Additional information

Funding

The authors thank Foundation for Research Support of the State of São Paulo (FAPESP) and Coordination of Improvement of Higher Education Personnel (CAPES) for their help.