ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-PO794

Low Protein Intake Is Associated with Severe Fatigue in Stable Outpatient Renal Transplant Recipients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Gomes Neto, Antonio Wouter, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Geelink, Marit, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Douwes, Rianne M., University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Van vliet, Iris, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Post, Adrian, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Rosmalen, Judith, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Joustra, Monica L., University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Knoop, Hans, University of Amsterdam, Academic Medical Center, Amsterdam, Netherlands
  • Berger, Stefan P., University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Navis, Gerjan, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Bakker, Stephan J.L., University of Groningen, University Medical Center Groningen, Groningen, Netherlands
Background

Severe fatigue is a frequent complaint in renal transplant recipients (RTR) that is often accompanied by functional impairment and poor quality of life. Low protein intake may lead to protein-energy malnutrition and thereby contribute to fatigue in RTR. We aimed to (1) compare the prevalence of severe fatigue between RTR and healthy controls, (2) investigate impact of severe fatigue on quality of life in RTR, and (3) investigate the association of protein intake with severe fatigue in RTR.

Methods

We included 601 stable RTR with a functioning graft >1 year and 237 prospective kidney donors from the TransplantLines Study. Overall fatigue was assessed using the Checklist Individual Strength (CIS) Questionnaire. A CIS-score >76 is commonly considered to indicate severe fatigue and was used as cut-off in this study. Quality of Life (QoL) was assessed with the RAND-36 Questionnaire. The Maroni formula was used to calculate protein intake from 24-hr urinary urea excretion. Chi-Square was used to test differences in prevalence of severe fatigue in RTR and donors. Mann-Whitney U was used to test differences in QoL of RTR with and without severe fatigue. Logistic regression was used to analyze the association between protein intake and presence of severe fatigue.

Results

RTR were 55 ± 13 years old, 347 (58%) were male and mean eGFR was 50 ± 18 ml/min/1.73m2. Thirty-three percent of RTR were severely fatigued compared to 6% of kidney donors (P<0.001). QoL was significantly lower in RTR with compared to RTR without severe fatigue (median QoL-score 40 [30-60] vs 60 [50-75], P<0.001). Mean protein intake in RTR was 1.0 ± 0.3 g per kg bodyweight per day. Protein intake was inversely associated with severe fatigue in RTR (OR 0.17; 95%CI 0.07-0.40 per g/kg/d, P<0.001). This association remained materially unchanged after adjustment for potential confounders, including age, sex, eGFR, BMI, and anaemia (OR 0.20; 95%CI 0.08-0.51 per g/kg/d, P=0.001).

Conclusion

Severe fatigue is highly prevalent in RTR and a determinant of poor quality of life. Low protein intake is associated with higher risk of severe fatigue in RTR, independent of potential confounders, including age, sex, eGFR, BMI, and anaemia.