Changing your lifestyle is not easy. What challenges do kidney transplant patients face if they want to eat healthier? What can help them change their diet? Karin Boslooper is a research physician at the Groningen University Medical Centre (UMCG) in the Netherlands. She wants to answer these, and other questions, in her study. She is looking at post-kidney transplant nutrition. In particular, what is needed to ensure that the patient's nutritional care better meets their needs.
'Before the surgery, patients with end-stage renal failure often have a very restricted diet. They could have potassium or protein restrictions. This is actually not very healthy. When they have had a successful transplant, these restrictions no longer apply. The aim, then, is that they can follow a mostly standard diet. We actually do not know how well this works. There are indications that people who have had kidney transplants eat fewer vegetables than the general population," she said.
Boslooper has so far led three group discussion with six to eight patients per group. She had been doing this since November last year. She is trying to collect a wide variety of experiences from these so-called focus groups. All the data still needs to be analysed. A number of issues are, however, already evident.
"Some participants had very restricted diets prior to their transplants. They find it difficult to change their routines. They have, for instance, been accustomed to eating very little fruit and vegetables for many years. This was due to potassium restrictions. Then it is very hard for them to follow a different routine and eat more fruit and vegetables. This is especially true patients who have received dialysis for many years while waiting for a suitable kidney. A number of patients are so devoted to their old diets that they keep following it. They think: I am following a good diet, so I will just keep it this way."
It is easier for patients to adjust something in their diet or other prescriptions when they receive feedback from blood and urine tests. This was found during earlier research done by the UMCG as well as the group discussions. "You can, for example, measure potassium in urine. You can then work out how much of this mineral a person gets per day. Many fruits and vegetables are rich in potassium", she explains.
A proactive partner also helps. "A partner that is involved and contributes ideas about what should and should not after a renal transplant. This can help tremendously to get someone to healthily. For example, some participants admitted that they do not help at all with food preparation. They eat what is put in front of them. Their wives will make sure they get fresh fruit every day, which they eat. If they are not served fresh fruit, however, they will not eat it."
Boslooper and her colleagues noticed that the partner's role is so important when it comes to what is being eaten at home. She is, therefore, going to hold several discussion groups with these partners over the next two months. She wants to get a better understanding of the role of the partners. She also wants to see if there is a need for guidance. A focus group with caregivers is also going to be organised. She wants to ascertain where the challenges are in the help these partners receive. She also wants to see where it can be improved.
Boslooper hopes all this data will be well analysed by the end of 2018. She then wants to write it up. "The next step is to see what kind of intervention we can use to stimulate a healthy diet. We want to do this by, among other things, better connecting nutritional care with the needs of the patient. We are doing this in collaboration with the Louis Bolk Institute. They are looking into how fruit and vegetable consumption can be increased in different settings. We are one of the centres participating in this project. The Institute is not only researching renal patients. They are also looking at young people with behavioural problems, older people with dementia and people in sports clubs. There is a wide range of places where they are trying to improve vegetable consumption," she concluded.
Source: NierNieuws