Malnutrition in kidney transplantation: Our experience and review of literature

Abstract

Malnutrition is a well-known determining factor in the clinical outcome of a patient posttransplant. Malnutrition encompasses the entire spectrum ranging from excess to deficiencies of calorie, protein, and macronutrient and micronutrient intake. Pre- and posttransplant nutritional status of the patient is directly proportional to the graft survival. The misperception that transplantation would appease dietary restrictions in conjunction with inadequate physical activity adds to the burden of posttransplant complications. Commonly encountered complications posttransplant include weight gain, hypertension, cardiovascular disease, and new-onset diabetes mellitus. While various studies have shown the effect of pretransplant serum phosphorus albumin, alkaline phosphatase, and body mass index on posttransplant functional graft survival, posttransplant malnutrition leading to an array of metabolic disorders can equally affect the same. The lack of standardized guidelines for the assessment and prevention of malnutrition specifically targeted at reducing posttransplant morbidity and mortality is the need of the hour. The focus must be on the implementation of a comprehensive patient-specific dietary and lifestyle plan made in collaboration by the patients treating physician, a skilled nutritionist, and family, taking into consideration adequate micronutrient and macronutrient requirements and patients' socioeconomic background.

Keywords

• graft survival posttransplantation
• micronutrient and macronutrient deficiency
• posttransplant malnutrition