Post Date December, 02 2023
Objective of nutritional therapy for renal transplantation
Patients with malnutrition after renal transplantation are prone to infection and cardiovascular diseases, which affect the quality of life of patients and increase the mortality rate. Therefore, it is of great significance for renal transplant patients to find and correct malnutrition in time, provide reasonable nutritional support, maintain or improve nutritional status.
At the same time, the trauma caused by surgery and the application of immunosuppressive agents and glucocorticoids after kidney transplantation will affect the metabolism of the body in varying degrees, resulting in a series of complications such as hypertension, hyperlipidemia, increased blood sodium and potassium, and decreased blood calcium and magnesium. This is also what nutritional treatment needs to be fully considered.
Home-based nutrition guidance
For kidney transplant patients who are recuperated at home, their appetite will usually improve quickly due to the use of conventional immunosuppressants. Therefore, we should give high quality protein, high vitamin and low salt diet to meet the needs of the body.
Energy - Post-transplantation weight gain is common. Therefore, energy intake should be properly controlled to maintain the standard weight (standard weight=height - 105cm). It is not only necessary to prevent weight loss from causing malnutrition, but also to prevent excessive weight gain from causing obesity and aggravating the kidney burden.
Protein - Because immunosuppressants and rejection reactions will accelerate protein catabolism and increase protein consumption, it is necessary to increase protein intake, which is 1.2-1.3g/kg for adults and 2-3g/kg for children to ensure growth and development. Two months after kidney transplantation, with the decrease of drug dose, the nutritional requirement will be reduced, and the long-term protein should be maintained at 1g/kg, which is the same as the normal diet of normal people.
Fat-fat metabolism changes after kidney transplantation, which easily leads to the increase of cholesterol and triglyceride. Therefore, fat supply is less than 30%, and cholesterol should be appropriately limited in diet.
Carbohydrate-glucose metabolism disorder is a common complication after kidney transplantation. It is necessary to properly control the intake of carbohydrates. It is recommended that carbohydrates account for 50% - 60% of the total energy, strictly limit the intake of monosaccharides, and select more complex carbohydrates, such as starch, coarse grains, etc. If diabetes has occurred, treat it as diabetes diet.
Potassium and sodium - adjust the intake of potassium and sodium according to the actual situation of the patient. The intake of potassium is related to the amount of urine. When the urine volume is normal, there is no need to limit it; However, when there is little or no urine, it is necessary to limit potassium intake. The intake of sodium depends on whether the patient has edema, hypertension and blood sodium level. The diet is usually low salt diet.
Precautions for daily diet
1. Prevent excessive weight gain: weight gain is fast in 1-2 months after operation, and weight should be properly controlled.
2. Avoid using foods and health products that improve immunity, such as propolis, ginseng, etc. So as not to reduce the efficacy of immunosuppressants.
3. Low-salt diet
4. Limit foods with high cholesterol: immunosuppressive agents can cause hyperlipidemia. Eat a light diet and avoid fried and fried foods. At the same time, it is necessary to limit the intake of dietary fiber in foods with high cholesterol content, such as animal viscera, pig's feet, fish roe, etc.
5. Choose complex sugars, strictly restrict simple sugars, eat less and eat more, and don't eat too much.
6. Ensure the intake of high-quality protein: fish, poultry, meat, eggs, milk and soybean products can be selected to provide rich high-quality protein.
7. Pay attention to calcium supplementation: immunosuppressive agents will lead to decreased calcium absorption and increased excretion, leading to osteoporosis. Choose foods rich in calcium and supplement vitamin D to promote absorption. Among them, dairy products are high in calcium and easy to absorb, which is a good choice for calcium supplement; More sunlight can also produce vitamin D and promote calcium absorption.
8. Food hygiene: because the immunity of kidney transplant patients is reduced, when choosing food, we must be fresh, good quality, and avoid using rotten food; Try to eat cooked food and cook cooked dishes.
