Nutrition in Chronic Kidney Disease: Nephrology Dialysis Transplantation Notable Advances in 2018

Philippe Chauveau

Disclosures

Nephrol Dial Transplant. 2019;34(6):893-896. 

In This Article

Fruit and Vegetable Intake in Renal Transplant Recipients

There is now established evidence that higher consumption of plant-based nutrients has favourable effects in the general population and in CKD patients. Cardiovascular mortality remains high in renal transplant recipients (RTRs). Little is known in this population about the relationship between healthier dietary patterns and mortality. Sotomayor et al.[14] included 400 RTRs in a prospective study. Patients with congestive heart failure or cancer were excluded. A semi-quantitative questionnaire was utilized. Patients chose between five possible frequency categories of consumption per day. Median follow-up was 7.2 years. The primary endpoint was cardiovascular mortality. The main known confounding factors (age, sex, physical activity, diabetes, cardiovascular history, etc.) were introduced in a multimodel Cox analysis. Vegetable consumption was inversely associated with all-cause mortality (see Figure 3, from their paper). Fruit consumption was also associated with less mortality, but only in early stages of CKD (from stages 1 to 3). Accurate dietary intake data are missing in the food frequency questionnaire, but this study demonstrates that we should pay more attention to the diet of RTRs.

Figure 3.

Kaplan–Meier curve for cardiovascular mortality according to categories of vegetable consumption (0–1, 2, ≥3 tablespoons/day) among RTRs. From Sotomayor et al. [14].

In conclusion, these five 'landmark' studies published in NDT in 2018 highlight new approaches to nutrition for CKD patients towards a healthy dietary pattern proposed for the general population and better use of medicines and dialysis techniques. An overly restrictive approach to nutrition for patients with renal insufficiency has been proposed over the past decades.

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