Said, M.Y. (Mohammad Yusof) (2014) Association of animal and plant protein with mortality and development of graft failure in renal transplant recipients. thesis, Medicine.
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Abstract
To date, it is unknown what influence of a low protein intake is on (graft) survival in RTR. Also, it is unknown what the influence is of the source of the protein (animal vs. vegetable) in RTR. In this thesis, we studied the associations of various types of protein intake with survival of RTR and with various renal function parameters. We recorded the (graft) survival of 636 RTR, along with hematological and urine parameters. Data on dietary intake of nutrients were obtained earlier via validated food frequency questionnaires. Additionally, total protein intake (TPI) was also determined with urinary urea and protein excretions, using the Maroni equation. With Kaplan-Meier and Cox regression analyses, we have analyzed the associations between the types of protein intake (per five grams) and (graft) survival of RTRs during a follow-up of 37 months. Associations were corrected for not only confounders, but also for variables possibly in the causal pathway, in order to explore underlying mechanisms of the associations. Linear and logistic regression analyses were applied to study associations between the types of protein intake (per five grams) and changes of urinary protein excretion, creatinine clearance, and eGFR over time. Unadjusted, Maroni TPI was associated with less mortality (hazard ratio: 0.89, P<0.001) and less graft failure (hazard ratio: 0.88, P=0.002). Significance for the association of graft failure and TPI was lost when adjusted for BMI. Underlying mechanisms of the association of mortality and TPI may be differences in potassium and sodium intake. Animal protein intake (API) showed similar associations with mortality. However, the association was less clear than the association of Maroni TPI and mortality. API was associated with yearly increase in urinary protein excretion (P=0.01). Maroni TPI was associated with yearly increase in eGFR (P=0.02). Higher protein intake in RTR may be beneficial for (graft) survival and API may be associated with less mortality. Furthermore, API is associated with increased proteinuria and Maroni TPI is associated with increased eGFR. More research is needed to confirm the results in a controlled setting.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Bakker, Prof. dr. SJL |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:06 |
| Last Modified: | 25 Jun 2020 11:06 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2558 |
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