Protein and calorie restriction may improve outcomes in living kidney donors and kidney transplant recipients

Franny Jongbloed, Ron W.F. de Bruin*, Harry Van Steeg, Piet Beekhof, Paul Wackers, Dennis A. Hesselink, Jan H.J. Hoeijmakers, Martijn E.T. Dollé, Jan N.M. Ijzermans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Scopus)
34 Downloads (Pure)

Abstract

Previously, we and others showed that dietary restriction protects against renal ischemia-reperfusion injury in animals. However, clinical translation of preoperative diets is scarce, and in the setting of kidney transplantation these data are lacking. In this pilot study, we investigated the effects of five days of a preoperative protein and caloric dietary restriction (PCR) diet in living kidney donors on the perioperative effects in donors, recipients and transplanted kidneys. Thirty-five kidney donors were randomized into either the PCR, 30% calorie and 80% protein reduction, or control group without restrictions. Adherence to the diet and kidney function in donors and their kidney recipients were analyzed. Perioperative kidney biopsies were taken in a selected group of transplanted kidneys for gene expression analysis. All donors adhered to the diet. From postoperative day 2 up until month 1, kidney function of donors was significantly better in the PCR-group. PCR-donor kidney recipients showed significantly improved kidney function and lower incidence of slow graft function and acute rejection. PCR inhibited cellular immune response pathways and activated stress-resistance signaling. These observations are the first to show that preoperative dietary restriction induces postoperative recovery benefits in humans and may be beneficial in clinical settings involving ischemia-reperfusion injury.

Original languageEnglish
Pages (from-to)12441-12467
Number of pages27
JournalAging-Us
Volume12
Issue number13
DOIs
Publication statusPublished - 2020

Bibliographical note

FUNDING:
This research was funded by a grant from the National
Institute for Public Health and the Environment and the
Ministry of Health, Welfare and Sports of The
Netherlands (S/340005). JHJH wishes to acknowledge
support from the National Institute of Health
(NIH)/National Institute of Ageing (NIA) (PO1
AG017242), European Research Council Advanced
Grants DamAge, and the KWO Dutch Cancer Society
(5030). The synthetic diet, Scandishake® Mix, was
kindly provided by Nutricia Advanced Medical
Nutrition upon our request. Neither the funders nor
Nutricia Advanced Medical Nutrition had any role in
study design, data collection and analysis, the decision
to publish, or the preparation of the manuscript.

Publisher Copyright:
©Jongbloed et al.

Research programs

  • EMC MGC-01-12-03
  • EMC OR-01

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