CHANGES IN DIET QUALITY AND THE INCIDENCE OF DIARRHOEA FOLLOWING KIDNEY TRANSPLANTATION – A PILOT STUDY

M MUKHERJEE1,  R LEU1,2,3,  C TRIMINGHAM2, N WATSON2,  S JESUDASON2,3,  P CLAYTON2, A MEADE2

1National Indigenous Kidney Transplantation Taskforce, South Australian Health and Medical Research Institute, Adelaide, Australia, 2Renal Home Therapies, Top End Health Service, Tiwi, Australia, 3Infectious Diseases Department, Fiona Stanley Hospital, Murdoch, Australia, 4Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, Australia, 5Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia, 6Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia, 7Central Australian Renal Services, Alice Springs, Australia, 8Flinders University, Adelaide, Australia, 9Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, Australia, 10Flinders Medical School, Flinders University, Darwin, Australia

Aim: The aim of this study was to assess diet quality and gastrointestinal (GI) symptoms, particularly diarrhoea, prior to and 2-weeks post kidney transplantation.
Background: Evidence suggests that kidney transplant recipients (KTR) continue to restrict their diet following transplantation.  Concurrently, adverse GI symptoms, particularly diarrhoea, are commonly reported within the first year.  Dietary intake and GI symptoms data in this population is lacking and inconsistent.
Methods: New KTR were recruited for this pilot observational study.  Questionnaires were completed prior to and 2-weeks post transplantation.  Dietary data were collected using a short food frequency screener designed to capture the intake of key food groups. Likert scale based questions were used to evaluate stool frequency. Stool consistency was determined with the Bristol Stool Form Scale.  A modified version of the Gastrointestinal Symptom Rating Scale assessed frequency of GI symptoms.  Wilcoxon signed-rank tests were used to analyse changes in stool frequency, consistency and GI symptoms and paired t-tests used to analyse changes in dietary intake.
Results: Preliminary data from ten participants (aged 48.7 ± 10.2 years, 50% males) showed intakes of wholegrain breads, minimally processed cereals and vegetables were inadequate post-transplant.  Stool frequency increased in all participants post-transplant (P = 0.03) with five participants reporting three to five bowel actions a day.  There was no change in stool consistency or worsening of GI symptoms post-transplant (P ≥ 0.05).
Conclusions: Diet quality remains low in KTR two weeks post-transplant and more frequent bowel actions were reported.  Larger studies are needed to confirm these preliminary findings.


Biography:
Anthony Meade is an Advanced Renal Dietitian at the Royal Adelaide Hospital in Adelaide, Australia and the convener of the Renal Nutrition Program.  He is never afraid to ask important questions and he is passionate about making renal nutrition more practical.

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