The effect of dietary intervention on the management of hyperlipidemia in British renal transplant patients

Abstract

• ■ Objective: To examine the effect of dietary intervention on hyperlipidemia in renal transplant patients. • ■ Design: Cohort of renal transplant patients randomized into a prospective 1-year study. • ■ Setting: Hospital outpatient renal transplant clinic. • ■ Patients: Matched hyperlipidemic renal transplant patients were randomized into either a control or experimental group. Exclusion criteria were total cholesterol less than 3.4 mmol/L (132.6 mg/dL), triglyceride less than 0.5 mmol/L (44.3 mg/dL), body mass index (BMI) less than 19 in female and less than 20 in male patients, proteinuria greater than 3.0 g/24 h, and diabetes. Thirteen male and 9 female patients (mean age, 50 years) were randomized into the experimental group, and 6 male and 10 female patients (mean age, 56 years) were randomized into the control group. • ■ Intervention: Dietary intake was assessed, and fasting serum lipids were measured at 1, 3, 6, and 12 months after transplant. BMI, smoking history, alcohol consumption, prednisolone, cyclosporin A, beta-blocker dose, and renal function were recorded at the same time points. The renal dietitian instructed the experimental group on the American Heart Association Step One Diet. • ■ Main outcome measures: Dietary intake as assessed using computer software and serum lipid levels. • ■ Results: Dietary intervention significantly increased polyunsaturated fat intake and decreased saturated fat intake, with a significant improvement in polyunsaturated-to-unsaturated fat ratio. There was no significant effect on serum lipid levels. • ■ Conclusion: Dietetic intervention is effective at changing selected dietary fats and should be considered for the initial treatment of hyperlidemia in renal transplant patients.