Mediteranska dieta kot način prehranjevanja za bolnike s presajeno ledvico

Rak, Larisa (author), Knap, Bojan (mentor)

Presaditev ledvice je najučinkovitejše zdravljenje ledvične odpovedi, saj omogoča znatno izboljšanje telesnega in socialnega stanja bolnika. Kljub odpravi strogih prehranskih omejitev, ki veljajo med dializo, so po presaditvi potrebne prilagoditve prehrane zaradi presnovnih sprememb in učinkov imunosupresivne terapije. Z raziskavo smo želeli oceniti prehranski vnos in telesno sestavo (TS), telesno pripravljenost in biokemične parametre bolnikov s presajeno ledvico in izvesti prehransko intervencijo (PI) z mediteransko dieto (MD), ki bi vplivala na izboljšanje TS in biokemičnih parametrov pri bolnikih s presajeno ledvico. V raziskavo je bilo vključenih 23 bolnikov s presajeno ledvico, razdeljenih v intervencijsko skupino (N = 11), ki je sledila MD z uporabo prilagojenih receptov, in kontrolno skupino (N = 12), ki je upoštevala standardna prehranska priporočila. Študijo je odobrila Komisija Republike Slovenije za medicinsko etiko (št. 0120-375/2023/3). Vsi udeleženci so pred in po šesttedenski intervenciji izpolnili 14-točkovni vprašalnik MEDAS (ang. Mediterranean Diet Adherence Screener), vodili tehtani tridnevni prehranski dnevnik (3PD), opravili meritve TS z bioimpedančno tehtnico (Akern BIA 101 BIVA®), test moči stiska pesti, test vstajanja s stola ter laboratorijske analize krvi. 3PD so bili analizirani s pomočjo programa Odprta platforma za klinično prehrano (OPKP), s katerim smo izračunali povprečni dnevni energijski in hranilni vnos. Skladnost z načeli MD smo ocenili na podlagi točk MEDAS. Statistična obdelava podatkov je bila izvedena v programu STATGRAPHICS Centurion 19, z uporabo deskriptivne statistike in t-testa za povezane vzorce. Statistično značilne razlike smo upoštevali pri p < 0,05, ob predpostavki, da je bil vzorec normalno porazdeljen. V intervencijski skupini smo po PI zaznali izboljšan prehranski vnos, zlasti povečanje vnosa energije, maščob in Ca, ter statistično značilno povečanje točk MEDAS (s 7,3 ± 1,6 na 10,6 ± 1,1), kar kaže na večjo skladnost s priporočili MD. Pred PI je bil prehranski vnos pogosto neustrezen, z nezadostnim vnosom energije, ogljikovih hidratov in Ca ter presežnim vnosom maščob in Na. Kljub izboljšavam v prehranskem vnosu MD ni pomembno vplivala na ledvično funkcijo, mišično moč ali parametre TS, verjetno zaradi kratkega trajanja intervencije in odsotnosti vadbenega programa. Glavna omejitev raziskave je majhna velikost vzorca in kratko trajanje spremljanja, zato rezultatov ni mogoče posplošiti na celotno populacijo bolnikov s kronično ledvično odpovedjo.

• Language: Slovenian
• Keywords: mediteranska dieta, prehrana, prehranske smernice, presajena ledvica, transplantacija ledvice
• Work type: Master's thesis/paper
• Organization: BF - Biotechnical Faculty
• Year: 2025
• PID: 20.500.12556/RUL-177546
• Publication date in RUL: 24.12.2025

Secondary language

• Language: English
• Title: Mediterranean diet as a way of eating for kidney transplant patients

Abstract

Kidney transplantation is the most effective treatment for kidney failure, as it enables a significant improvement in the patient’s physical and social well-being. Despite the removal of strict dietary restrictions required during dialysis, dietary adjustments after transplantation are necessary due to metabolic changes and the effects of immunosuppressive therapy. The aim of the study was to assess the dietary intake and body composition (BC), physical fitness, and biochemical parameters of kidney transplant recipients, and to carry out a dietary intervention (DI) with the Mediterranean diet (MD) to improve BC and biochemical parameters in these patients. The study included 23 kidney transplant recipients, divided into an intervention group (N = 11), which followed the MD using adapted recipes, and a control group (N = 12), which followed standard dietary recommendations. The study was approved by the National Medical Ethics Committee of the Republic of Slovenia (No. 0120-375/2023/3). All participants completed the 14-item MEDAS questionnaire (Mediterranean Diet Adherence Screener), kept a weighed three-day food diary (3FD), and underwent BC measurements with a bioimpedance scale (Akern BIA 101 BIVA®), a handgrip strength test, a chair-stand test, and laboratory blood analyses before and after the six-week intervention. The 3FDs were analyzed using the Open Platform for Clinical Nutrition (OPKP), which was used to calculate the average daily energy and nutrient intake. Adherence to the MD principles was assessed based on MEDAS scores. Statistical analysis was performed using STATGRAPHICS Centurion 19, applying descriptive statistics and paired t-tests. Statistically significant differences were considered at p < 0.05, assuming a normally distributed sample. In the intervention group, we observed improved dietary intake after the DI, particularly an increase in energy, fat, and Ca intake, as well as a statistically significant increase in MEDAS scores (from 7.3 ± 1.6 to 10.6 ± 1.1), indicating greater adherence to MD recommendations. Before the DI, dietary intake was often inadequate, with insufficient energy, carbohydrate, and Ca intake and excessive fat and Na intake. Despite improvements in dietary intake, the MD did not significantly affect kidney function, muscle strength, or BC parameters, likely due to the short duration of the intervention and the absence of an exercise program. The main limitations of the study are the small sample size and short follow-up period; therefore, the results cannot be generalized to the entire population of patients with chronic kidney disease.

• Keywords: mediterranean diet, nutrition, dietary guidelines, transplanted kidney, kidney transplantation