NUTRITION GUIDELINES FOR CRF PATIENTS

A long felt need in the case of children and adults with chronic renal failure has been addressed by the National Kidney Foundation, USA. It had released the K/DOQ/Clinical Practice guidelines for Nutrition in Chronic Renal Failure. The guidelines include two important issues:

A. Recommendations for evaluating protein – energy nutritional status.

B. Prescribing appropriate levels of dietary energy and protein intake.

Cold Ischaemia Time Important Factor in Outcome of Kidney Transplant

Prolonged cold ischemia time versus better HLA matching and their impact on the outcomes of renal transplant has been the subject  of a study ny John Roberts, MD  and colleagues of the university  Of California, San  Francisco.

They analysed data from 63,688 recipients of cadaveric renal transplants reported to UNOS scientific registry between 1990 and 1998. The findings were reported in the Archives of Surgery Sept 2000. It was found that that five year graft survival was significantly associated with cold ischaemic time. The rates were 68.3%, 63.1% and 59.9% for grafts kept cold  for less than 24,  24-36 and longer than 36 hours.  HLA matching also affected the 5 year survival rate, which was 71.35 in recipients with zero mismatches least one mismatch.

However recipients of kidneys with zero mismatch but with cold ischemia time greater the 36 hours has no survival advantage over patients with mismatched kidneys kept cold for less than 24 hours. Delayed graft function appeared to be affected more by cold ischemia time than by the number of HLA mismatches.