Lin I-Hsin, Wong Te-Chih, Nien Shih-Wei, Chou Yu-Ting, Chiang Yang-Jen, Wang Hsu-Han, Yang Shwu-Huey
Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.
Department of Nutrition and Health Sciences, Chinese Culture University, Taipei, Taiwan.
Transplant Proc. 2019 Jun;51(5):1325-1330. doi: 10.1016/j.transproceed.2019.02.026. Epub 2019 May 2.
Extensive food and lifestyle changes are the major issues in renal transplant recipients (RTRs). Poor adherence to diet can contribute to increased health problems such as obesity, cardiovascular disease, and graft failure; however, comparative data regarding dietary compliance with the national recommendations has rarely been investigated, especially among RTRs in Taiwan.
In this descriptive analytical study, we compared patients' reported dietary intake of macronutrients and micronutrients with evidence-based guidelines developed for the nutritional management of adult kidney transplant recipients (NMAKTR) by the Dietitians Association of Australia. A total of 90 maintenance-phase RTRs were recruited from September 2016 to June 2018. All patients completed a 3-day dietary record (2 weekdays and 1 day on the weekend). In addition, routine anthropometric and laboratory data were obtained.
The mean age, post-transplant years, and estimated glomerular filtration rate of participants were 49.7 ± 12.5 years, 9.1 ± 6.1 years, and 55.5 ± 20.8 mL/min/1.73 m, respectively. Daily energy and protein intakes were 1869.1 ± 383.5 kcal (30.4 ± 7.2 kcal/kg/d) and 66.9 ± 14.4 g (1.1 ± .2 g/kg/d), respectively. The percentage of energy intake from fat and saturated fat exceeded recommendations, whereas dietary fibers and calcium remained less than the recommended levels. At our center, a large percentage of RTRs did not meet NMAKTR dietary recommendations.
The low degree of dietary compliance calls for a continued effort to deliver effective nutritional advice in this population.
广泛的饮食和生活方式改变是肾移植受者（RTR）面临的主要问题。饮食依从性差会导致肥胖、心血管疾病和移植失败等健康问题增加；然而，关于饮食是否符合国家建议的比较数据很少被研究，尤其是在台湾的肾移植受者中。
在这项描述性分析研究中，我们将患者报告的常量营养素和微量营养素饮食摄入量与澳大利亚营养师协会为成人肾移植受者营养管理制定的循证指南（NMAKTR）进行了比较。2016年9月至2018年6月共招募了90名维持期肾移植受者。所有患者都完成了一份3天的饮食记录（2个工作日和1个周末日）。此外，还获取了常规人体测量和实验室数据。
参与者的平均年龄、移植后年限和估计肾小球滤过率分别为49.7±12.5岁、9.1±6.1年和55.5±20.8 mL/min/1.73 m²。每日能量和蛋白质摄入量分别为1869.1±383.5千卡（30.4±7.2千卡/千克/天）和66.9±14.4克（1.1±0.2克/千克/天）。脂肪和饱和脂肪的能量摄入百分比超过了建议值，而膳食纤维和钙的摄入量仍低于建议水平。在我们中心，很大一部分肾移植受者未达到NMAKTR饮食建议。
饮食依从性低表明需要继续努力为这一人群提供有效的营养建议。
