Dietary Analysis of Kidney Transplant Patients Who Eat Korean Foods: Single Center Study

Sae Kim Han; Seok Oh Joon; Yeol Lee Dong; Ho Lee Jin; Min Kim Seung; Hun Shin Yong; Soon Park Yong; Suk An Won; Kyung Kim Joong

doi:10.4285/jkstn.2015.29.2.68

Journal List > J Korean Soc Transplant > v.29(2) > 1034480

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Han, Joon, Dong, Jin, Seung, Yong, Yong, Won, and Joong: Dietary Analysis of Kidney Transplant Patients Who Eat Korean Foods: Single Center Study

Original Article

J Korean Soc Transplant 2015;29(2):68-74.

Published online: 10 June 2015

DOI: https://doi.org/10.4285/jkstn.2015.29.2.68

Dietary Analysis of Kidney Transplant Patients Who Eat Korean Foods: Single Center Study

Sae Kim Han, M.D.¹, Seok Oh Joon, M.D.¹, Yeol Lee Dong, M.D.¹, Ho Lee Jin, M.D.¹, Min Kim Seung, M.D.¹, Hun Shin Yong, M.D.¹, Soon Park Yong, Ph.D.², Suk An Won, M.D.³, Kyung Kim Joong, M.D.¹

¹Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea

²Busan, Department of Food and Nutrition, Hangyang University College of Human Ecology, Busan, Korea

³Seoul, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea

Corresponding author: Joon Seok Oh, Department of Internal Medicine, Bong Seng Memorial Hospital, 401 Jungang-daero, Dong-gu, Busan 601-723, Korea Tel: 82-51-664-4224, Fax: 82-51-664-4219 E-mail: j-seok@hanmail.net

Received 12 September 2014 Revised 26 June 2015 Accepted 26 June 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Although nutritional problems associated with dialysis are well described, nutritional problems after renal transplantation have received little attention. Nutrition interventions play an important role in prevention and management of common health problems associated with renal transplantation such as obesity, hypertension, diabetes, and cardiovascular disease.

Methods

Sixty-four kidney transplant recipients who received post-transplant management at our hospital replied to the questionnaire. The questionnaire included 102 questions on the amount and types of Korean foods that they consumed last week. Nutritional elements of diet in renal transplant patients who consume Korean food were analyzed on the basis of the survey.

Results

The mean energy and protein of daily intake were 2,088±1,016 kcal and 75.5±38.2 g. Patients’ diets were generally sufficient, but characterized by deficiencies in vitamin B2, vitamin D, niacin, calcium, and magnesium intake.

Conclusions

Dietary advice is required with regard to intake of some nutritional elements for kidney transplant recipients who consume Korean foods. Their main nutritional problem is obesity after transplantation. Attention should be paid to prevention of nutritional imbalance.

Keywords: Kidney transplantation, Nutrition, Diet

References

1). Kahra T, Jenssen T, Lovik A. Dietary intakes differ between renal transplant recipients living in patient hotels versus home. J Ren Nutr. 2004; 14:101–8.

2). Heaf J, Jakobsen U, Tvedegaard E, Kanstrup IL, Fogh-Andersen N. Dietary habits and nutritional status of renal transplant patients. J Ren Nutr. 2004; 14:20–5.

3). Friedman AN, Miskulin DC, Rosenberg IH, Levey AS. Demographics and trends in overweight and obesity in patients at time of kidney transplantation. Am J Kidney Dis. 2003; 41:480–7.

4). Kent PS. Issues of obesity in kidney transplantation. J Ren Nutr. 2007; 17:107–13.

5). Moore LW, Gaber AO. Patterns of early weight change after renal transplantation. J Ren Nutr. 1996; 6:21–5.

6). Bellinghieri G, Bernardi A, Piva M, Pati T, Stoppa F, Scaramuzzo P, et al. Metabolic syndrome after kidney transplantation. J Ren Nutr. 2009; 19:105–10.

7). Dumler F, Kilates C. Metabolic and nutritional complications of renal transplantation. J Ren Nutr. 2007; 17:97–102.

8). Chan M, Patwardhan A, Ryan C, Trevillian P, Chadban S, Westgarth F, et al. Evidence-based guidelines for the nutritional management of adult kidney transplant recipients. J Ren Nutr. 2011; 21:47–51.

9). Strejc J. Nutrition guidelines after kidney transplantation. J Ren Nutr. 2000; 10:161–7.

10). Teplan V, Valkovsky I, Teplan V Jr, Stollova M, Vyhnanek F, Andel M. Nutritional consequences of renal transplantation. J Ren Nutr. 2009; 19:95–100.

11). Bernardi A, Biasia F, Pati T, Piva M, D'Angelo A, Bucciante G. Long-term protein intake control in kidney transplant recipients: effect in kidney graft function and in nutritional status. Am J Kidney Dis. 2003; 41(3 Suppl 1):S146–52.

12). Fouque D, Wang P, Laville M, Boissel JP. Low protein diets for chronic renal failure in non diabetic adults. Cochrane Database Syst Rev. 2001; (2):CD001892.

13). Cupisti A, D'Alessandro C, Ghiadoni L, Morelli E, Panichi V, Barsotti G. Effect of a soy protein diet on serum lipids of renal transplant patients. J Ren Nutr. 2004; 14:31–5.

14). Teplan V. Effect of keto acids on asymmetric dimethylargi-nine, muscle, and fat tissue in chronic kidney disease and after kidney transplantation. J Ren Nutr. 2009; 19(5 Suppl):S27–9.

15). Montori VM, Basu A, Erwin PJ, Velosa JA, Gabriel SE, Kudva YC. Posttransplantation diabetes: a systematic review of the literature. Diabetes Care. 2002; 25:583–92.

16). Kasiske BL, Snyder JJ, Gilbertson D, Matas AJ. Diabetes mellitus after kidney transplantation in the United States. Am J Transplant. 2003; 3:178–85.

17). Hur KY, Kim MS, Kim YS, Kang ES, Nam JH, Kim SH, et al. Risk factors associated with the onset and progression of posttransplantation diabetes in renal allograft recipients. Diabetes Care. 2007; 30:609–15.

Table 1.

Characteristics of study participants

Characteristic	Value
Number	64
Age (yr)	56.5±19.5
Gender, male/female	43/21 (67.2/32.8)
Transplant age (mo)	145.4±73.6
Weight at transplantation (kg)	62.6±13.0
Weight at study time (kg)	64.3±11.8
BMI at transplantation (kg/m²)	22.1±3.2
BMI at study time (kg/m²)	22.7±3.0
Fat weight at study time (kg)	14.5±8.8
Percentage fat at study time (%)	21.0±12.1
Lean body mass at study time (kg)	49.8±6.2
Etiology
Glomerulonephritis/nephropathy	48 (75.0)
IgA nephropathy	3 (4.7)
Hypertension	0
Diabetes mellitus	5 (7.8)
Obstructive uropathy	1 (1.6)
Unknown and others	2 (3.1)
Graft failure (more than 2nd KT)	6 (9.4)
Type of donor, LR/LUR/D	40/15/9 (62.5/23.4/14.1)
Blood urea nitrogen (mmol/L) ^a	8.0±5.4
Plasma creatinine ( mol/L) ^a	133.6±83.5
Creatinine clearance (mL/min) ^a	67.9±29.1
Plasma protein (g/L) ^a	70.2±6.5
Plasma albumin (g/L) ^a	42.5±4.4
Serum hemoglobin (g/dL) ^a	13.1±1.9
Fasting plasma glucose (mmol/L) ^a	5.9±1.8
HbA1c (%) ^a
Non-diabetes (n=38)	5.3±0.4
NODAT (n=21)	6.4±1.3
Diabetes mellitus (n=5)	8.3±2.1
Plasma total cholesterol (mmol/L) ^a	5.1±1.2
Plasma LDL-C (mmol/L) ^a	2.9±0.9
Plasma HDL-C (mmol/L) ^a	1.5±0.4
Plasma triglycerides (mmol/L) ^a	1.9±1.6

Data are presented as mean±SD or number (%).

Abbreviations: BMI, body mass index; IgA, immunoglobulin A; KT, kidney transplantation; LR, living related; LUR, living unrelated; D, deceased; NODAT, new onset diabetes after transplantation; LDL-C, low density lipoprotein cholesterol; HDL-C, high density lipoprotein cholesterol.

^a At study time.

Table 2.

Nutritional analysis in kidney transplant recipient who eat Korean foods

Variable	Mean±SD	Minimum∼ Maximum	No. patients with recommended intake (%)	Recommendation
Energy (kcal/day)	2,088±1,016	171∼5,264
Energy (kcal/kg IBW/day)	34.7±18.2	2.5∼80.4	17 (27)	30∼35
Carbohydrate (g/day)	357.2±182.2	22.9∼1,034
% Energy	68.2±7.9	52.5∼83.0
Fat (g/day)	42.3±24.2	5.6∼125.3
% Energy	18.5±6.0	5.6∼32.9	27 (42)	20∼30
% Animal fat	46.3±13.7	19.3∼66.1	8 (13)	25∼35
Protein (g/day)	75.5±38.2	7.7∼186.8
Protein (g/kg IBW/day)	1.26±0.69	0.11∼3.10	17 (27)	0.6∼0.8
% Energy	14.5±2.4	8.7∼20.8	42 (66)	10∼15
% Animal protein	40.5±12.4	3.7∼66.2
Dietary fiber (g/day)	27.0±15.8	2.0∼97.0
Water (g/day)	2,230±654	1,135∼5,170	41 (64)	＞2,000
Ash (g/day)	18.5±11.6	1.8∼77.0
Vitamin A ( g R.E./day)	1,307±1,372	89∼10,434	61 (95)	＞270
Vitamin B1 (mg/day)	1.5±0.8	0.1∼4.0	31 (48)	＞1.4
Vitamin B2 (mg/day)	1.2±0.7	0.1∼4.0	12 (19)	＞1.6
Vitamin B6 (mg/day)	1.9±0.9	0.2∼4.8	41 (64)	＞1.5
Vitamin B12 ( g/day)	8.2±5.4	0.8∼24.2	62 (97)	＞2
Vitamin C (mg/day)	135.9±95.5	8.96∼519.9	49 (77)	＞60
Vitamin D ( g/day)	6.6±4.7	0.1∼21.6	35 (55)	＞5
Vitamin E (mg/day)	15.6±9.5	1.7∼53.3
Vitamin K ( g/day)	208.6±165.9	27∼1,133
Folic acid ( g/day)	613.4±370.2	52∼2,344	52 (81)	＞300
Niacin (mg/day)	16.1±8.2	1.7∼39.7	22 (34)	＞18
Panthothenic acid (mg/day)	6.6±8.2	0.5∼17.4
Biotin ( g/day)	24.6±12.4	2.4∼66.8
Sodium (mg/day)	3,417±2,616	472∼17,524	32∼49 (70∼77)	＜3,000∼4,000
Potassium (mg/day)	3,593±2,101	277∼13,869	28 (44)	＞3,500
Chloride (mg/day)	568.3±591.4	55∼4,623
Calcium (mg/day)	618.9±400.3	39.6∼2,501	8 (13)	800∼1,500
Phosphate (mg/day)	1,272±658	106.4∼3,515	56 (88)	＞600
Magnesium (mg/day)	91.3±56.4	7.2∼289	3 (5)	200∼300
Iron (mg/day)	16.9±9.0	1.3∼50.7	50 (78)	＞10
Zinc (mg/day)	12.5±6.2	1.1∼27.9	46 (72)	＞9
Copper (mg/day)	1.6±0.8	0.1∼3.8
Fluorine ( g/day)	23.2±13.3	1.6∼74.0
Manganese (mg/day)	4.9±2.6	0.3∼14.2
Iodine ( g/day)	267.2±358.5	8.8∼2,446	39 (61)	＞150
Selenium ( g/day)	93.7±44.8	8.8∼219.5	53 (83)	＞50
Cholesterol (mg/day)	280.9±182.4	8.8∼825.4

Abbreviations: IBW, ideal body weight; R.E., retinol equivalents.

TOOLS

Similar articles