Comprehensive lifestyle modification as complementary therapy to prevent and manage post-transplant diabetes mellitus*
, , and | Apr 08, 2021
About this article
Article Category: Original Article
Published Online: Apr 08, 2021
Page range: 238 - 245
Received: Apr 13, 2020
Accepted: Nov 09, 2020
DOI: https://doi.org/10.5604/01.3001.0014.8311
Keywords
© 2021 Katarzyna Madziarska et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Nutritional recommendations for patients with Chronic Kidney Disease (CKD) [30, 31]
| CHRONIC KIDNEY DISEASE | ||
|---|---|---|
| Hemodialysis [HD] | Peritoneal dialysis [PD] | |
| Protein | 1.2 g/kg [stage 5 CKD] | 1.2–1.3 g/kg [stage 5 CKD] |
| Energy | 30–35 kcal/kg/day | 30–35 kcal/kg/day |
| Fat | 30% kcal | 30% kcal |
| Fluids | Loss with urine + 500–1000 ml | Loss with urine + 1000 ml |
| Electrolytes and minerals | < 2.4 g sodium/day |
2 g sodium/day |
| Vitamins | 3 µg vitamin B12 | |
| 1–5 mg/day folic acid | ||
| 1.5–2mg/day vitamin B1 | ||
Risk factors for the development of post-transplant diabetes mellitus PTDM [15, 26, 27]
| Overweight (BMI > 25 kg/m2) or Obesity (BMI > 30 kg/m2) | Positive family history of type 2 diabetes |
| Hepatitis C (HCV) | Age at day of transplantation (> 40 years) |
| Cytomegalovirus infection (CMV) | Ethnic origin (African-Americans, Hispanics) |
| Hypertension | Polycyclic kidney disease – ADPKD |
| Immunosuppression | HLA A26 or B27 |
| Low physical activity | Male gender |
| Smoking | Peritoneal dialysis |
| Pre-diabetes conditions (impaired fasting glucose IFG and/or impaired) | |
| Hypertriglyceridemia |
Nutritional recommendations for kidney transplantation patients [30, 31]
| POST-KIDNEY TRANSPLANTATION | ||
|---|---|---|
| ACUTE PHASE | CHRONIC PHASE | |
| Protein | 1.2–2.0 g/kg | 0.6–0.8 g/kg |
| Energy | 30–35 kcal/kg | 25–30 kcal/kg |
| Fat | 30–50% low-fat products | < 30% kcal |
| Carbohydrates | 50–70% kcal | 45–50% kcal |
| Electrolytes and minerals | without salt |
|
| vitamin D supplementation | ||