Is limiting protein intake for kidney transplant patients truly healthy?

Patients with renal illness, common wisdom holds, should eat a low-protein diet. Osaka Metropolitan University researchers found that this is not always the case in their recent study on the association between protein consumption and skeletal muscle mass in kidney transplant patients. Their findings were reported in Clinical Nutrition.

Patients with chronic renal illness have been demonstrated to have induced sarcopenia as a result of chronic inflammation, hypercatabolism, reduced nutritional intake, and decreased physical activity, all of which are linked to poor kidney function. A successful kidney transplant can fix or improve many of these physiological and metabolic problems.

As a result, after having a kidney transplant, kidney transplant patients acquire skeletal muscle mass. Because excessive protein consumption compromises kidney function, it is commonly accepted that individuals with chronic renal disease, including kidney transplant recipients, should restrict their protein intake to protect their kidneys. In contrast, severe protein restriction has been associated to progressive sarcopenia and a bad prognosis.

Because diet and exercise treatment are suggested to treat sarcopenia, protein consumption is assumed to be connected to the recovery of skeletal muscle mass following kidney donation. However, few studies have looked at the relationship between skeletal muscle mass and protein consumption in kidney transplant patients.

To fill this void, a research team led by Dr. Akihiro Kosoku, Dr. Tomoaki Iwai, and Professor Junji Uchida at Osaka Metropolitan University’s Department of Urology, Graduate School of Medicine investigated the relationship between changes in skeletal muscle mass (as measured by bioelectrical impedance analysis) and protein intake (as estimated from urine collected from 64 kidney transplant recipients 12 months after transplantation). The data demonstrated that changes in skeletal muscle mass were positively linked with protein consumption over this time period, and that a shortage of protein resulted in muscle mass loss.

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“Further study is needed to define the appropriate protein intake to prevent either worsening in renal function or sarcopenia in kidney transplant recipients,” Drs. Iwai and Kosoku remarked. We anticipate that dietary counselling, including protein consumption, will increase life expectancy and prognosis.”

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