Changes in the Quality of Life and Nutrition Markers in Transition From End-Stage Kidney Disease to Kidney Transplantation: Insights From a Vietnamese Cohort.

Background Malnutrition is strongly associated with lower quality of life (QoL) and lower survival rates in patients with end-stage kidney disease. However, the impact of renal transplantation on nutrition factors and QoL is unclear. Therefore, this study aims to assess changes in QoL and investigate the relationships with nutrition factors among kidney transplant recipients (KTRs). Materials and methods A longitudinal study included 86 dialysis patients aged 18-65 years who underwent primary kidney transplantation (KTx) and were followed up for one year. Body weight, biochemical parameters, and QoL data were collected before transplantation (T0) and at six months (T6) and 12 months (T12) post-transplantation. Effect size (ES) was used to measure the impact of KTx on QoL and nutritional status from T0 to T12. The predictors of QoL were calculated with ß-coefficients and p<0.05 in linear regression. Results The ES of transplantation on the QoL of KTRs was large, at 1.1 for health change, 0.9 for physical health, and moderate (0.7) for mental health (MH) over one year. Hemoglobin and malnourished were affected by KTx, with ES being 2.4 and 0.6, respectively. Linear regression showed that physical health was predicted by hemoglobin (ß=0.12, p<0.01), phosphorus (ß=7.82, p<0.05), and dose of mycophenolate mofetil (MMF) (ß=-0.01, p<0.05). Mental health was predicted by obesity (ß=-7.63, p<0.05), hemoglobin (ß=0.11, p<0.05), and phosphorus (ß=8.49, p<0.01). Health change was indicated by nutritional risk index (NRI) score (ß=0.47, p<0.05), total cholesterol (ß=3.39, p<0.01), and kidney function (ß=0.15, p<0.05). Conclusions The transition from end-stage kidney disease to transplantation has positive impacts on QoL and nutrition markers. Nutritional status, kidney function, and the dose of mycophenolate mofetil are significant determinants of QoL in KTRs.

Metabolic Syndrome and Dietary Intake are Associated With Quality of Life in Kidney Transplant Recipients.

BACKGROUND: Although metabolic syndrome (MetS) is a significant risk factor, and dietary intake may affect the quality of life (QoL) of kidney transplant recipients (KTRs), the association between them are unclear. This study identified MetS and nutritional factors associated with the QoL of KTRs. METHODS: This study reports baseline data from a longitudinal study that was conducted at a hospital in Vietnam. KTRs aged ≥18 years and >3 months post-transplantation were recruited. Assessments included sociodemographic and blood biomarkers. Dietary intake was estimated from 24-hour recalls. A Short Form-36 Health Survey, comprising physical (PCS) and mental component summaries (MCS), was administered to assess QoL. Multivariate linear regression models were performed. RESULTS: The study included 106 patients (79 men) with a mean age of 43.2 years (± 11.9). Mean duration after kidney transplantation was 28.5 months (± 14.9). Patients with MetS had 6.43 lower PCS score (P < .05) and 3.20 lower MCS score (P < .05) than their counterparts without MetS. Calcium intake (ß = -0.01; 95% CI, -0.03 to 0.00) and inadequate protein (ß = -14.8; 95% CI, -23 to -6.65) were negatively associated with PCS score. MCS score was negatively associated with calcium intake (ß = -0.02; 95% CI, -0.04 to -0.01) and inadequate protein intake (ß = -15.1; 95% CI, -24.3 to -5.86), and positively associated with fat intake (ß = 0.43, 95% CI, 0.02-0.85). CONCLUSIONS: MetS and poor dietary intake are independently associated with the QoL of KTRs. Nutritional intervention plans developed specifically for the recipients will improve dietary intake, reduce the incidence of MetS, and help enhance QoL.

Nutritional Assessment of Pre-School Children in Rural Villages of the Family Dynamics, Lifestyles and Nutrition Study (1997-2001) II. Prevalence of Undernutrition and Relationship to Household Socio-Economic Indicators.

This paper describes the nutritional status of pre-school children and analyzes its relationship to various household socio-economic indicators. Padi, rubber and fishing villages from the Functional Groups Study (1992-1996) were selected for having a high prevalence of child undernutrition, and all children between the ages of 12 and 72 months were measured for their weights and heights in April-May 1998. The NCHS reference values were used to calculate z-scores, which were categorised according to WHO (1983) recommendations. Children between minus 2SD and minus 1SD of reference median were classified as mildly malnourished. Prevalence of underweight was higher (30.5%) than stunting (22.3%), while wasting was only 9.7%. Padi villages had the highest prevalence of undernutrition, followed by fishing, and then rubber villages. Mean household incomes were found to be significantly lower for children with worse nutritional status, and undernutrition was higher in households below the poverty line income. The odds ratios for having stunted children were significantly higher for households whose heads were agricultural own-account workers (OR 3.66, 95% CI = 1.37-9.79), agricultural waged workers (OR 2.75, 95% CI = 1.06-7.10), and non-agricultural manual workers (OR 2.49, 95% CI = 1.04-6.00) compared to non-manual workers. Various household socio-economic indicators showed significantly higher odds ratios for underweight, stunting and wasting. After adjusting for confounding effects by logistic regression analysis, however, only mother's education was found to be a significant predictor for stunting, while poverty level and access to piped water supply were significant predictors for both underweight and stunting. Households without livestock were significant predictors for wasting. Thus, this study identified specific socio-economic factors that should be prioritized for policy and research towards the amelioration of childhood malnutrition in rural areas.