Henggeler CK, et al. - Researchers investigated if an intensive nutrition and exercise intervention delivered alongside routine post-transplant care would attenuate post-transplant weight gain in kidney transplant recipients. Relative to standard nutrition care, no benefit of an intensive nutrition intervention was seen among kidney transplant recipients in the first year after transplant. In both groups, relatively modest weight gain was observed.

Methods

• This single-blind, randomized controlled trial was performed in adult kidney transplant recipients recruited at a regional transplant center during routine outpatient clinic visits in the first month after transplant, excluding those with a body mass index >40 kg/m² or <18.5 kg/m², severe malnutrition, or ongoing medical complications.
• Standard nutrition care (guideline based; 4 dietitian visits) or intensive nutrition intervention (individualized nutrition and exercise counselling; 12 dietitian visits; 3 exercise physiologist visits over 12 months) was implemented in a randomized manner among the participants.
• The primary outcome was weight at 6 months after transplant adjusted for baseline weight, obesity, and gender, analyzed using analysis of covariance.
• Body composition, biochemistry, quality of life, and physical function were secondary outcomes.

Results

• Data showed that 37 participants were randomized to the intensive intervention (n = 19) or to standard care (n = 18); one intensive group participant withdrew before baseline.
• Between baseline, 6 and 12 months, an increase in weight was noted (78.0 ± 13.7 [standard deviation], 79.6 ± 13.0 kg, 81.6 ± 12.9 kg; mean change 4.6% P < .001) but at 6 months no significant difference was evident between the groups: 77.0 ± 12.4 kg (intensive); 82.2 ± 13.4 kg (standard); difference in adjusted means 0.4 kg (95% confidence interval: -2.2 to 3.0 kg); analysis of covariance P=.7.
• Researchers noted no between-group differences in secondary outcomes.
• Across the whole cohort, improvement in total body protein and physical function (gait speed, sit to stand, grip strength, physical activity, and quality of life [all but 2 domains]) was reported.
• However, for total body fat, HbA1c, and fasting glucose, adverse changes were seen across the cohort.