Preoperative dietary intake of low-dose sulforaphane induces no clinically significant effect in living donor kidney transplantation

Introduction: Sulforaphane (SFN) has anti-inflammatory properties, and is found in broccoli sprouts. Studies suggest that it protects against disease due to its anti-inflammatory activity. The impact of SFN on healthy people undergoing a surgical procedure has not been investigated. Objective: To explore the effect of SFN in living kidney donors on the postoperative inflammatory response and recovery. Methods: We performed a double-blind randomised controlled trial where donors followed a SFN-enriched (8 mg) preoperative diet. Results:A total of 42 donors were included, there were no significant differences at baseline. Postoperative inflammatory response was consistent among both arms and subjective recovery showed no significant difference. Findings regarding postoperative kidney function suggest no consistently significant impact. Discussion: A well-defined SFN-enriched diet did not have anti-inflammatory or a clinically relevant effect on the outcome. Due to the complexity of dietary modification of the inflammatory response, additional research is needed.</p

Preoperative dietary intake of low-dose sulforaphane induces no clinically significant effect in living donor kidney transplantation

Introduction: Sulforaphane (SFN) has anti-inflammatory properties, and is found in broccoli sprouts. Studies suggest that it protects against disease due to its anti-inflammatory activity. The impact of SFN on healthy people undergoing a surgical procedure has not been investigated. Objective: To explore the effect of SFN in living kidney donors on the postoperative inflammatory response and recovery. Methods: We performed a double-blind randomised controlled trial where donors followed a SFN-enriched (8 mg) preoperative diet. Results:A total of 42 donors were included, there were no significant differences at baseline. Postoperative inflammatory response was consistent among both arms and subjective recovery showed no significant difference. Findings regarding postoperative kidney function suggest no consistently significant impact. Discussion: A well-defined SFN-enriched diet did not have anti-inflammatory or a clinically relevant effect on the outcome. Due to the complexity of dietary modification of the inflammatory response, additional research is needed.</p

Long-Term Kidney and Maternal Outcomes After Pregnancy in Living Kidney Donors

For counseling it is important to know if pregnancy after Living Kidney Donation (LKD) affects long-term outcomes of the mono-kidney and the mother. Therefore, we performed a retrospective multicenter study in women ≤45 years who donated their kidney between 1981 and 2017. Data was collected via questionnaires and medical records. eGFR of women with post-LKD pregnancies were compared to women with pre-LKD pregnancies or nulliparous. eGFR before and after pregnancy were compared in women with post-LKD pregnancies. Pregnancy outcomes post-LKD were compared with pre-LKD pregnancy outcomes. 234 women (499 pregnancies) were included, of which 20 with pre- and post-LKD pregnancies (68) and 26 with only post-LKD pregnancies (59). Multilevel analysis demonstrated that eGFR was not different between women with and without post-LKD pregnancies (p = 0.23). Furthermore, eGFR was not different before and after post-LKD pregnancy (p = 0.13). More hypertensive disorders of pregnancy (HDP) occurred in post-LKD pregnancies (p = 0.002). Adverse fetal outcomes did not differ. We conclude that, despite a higher incidence of HDP, eGFR was not affected by post-LKD pregnancy. In line with previous studies, we found an increased risk for HDP after LKD without affecting fetal outcome. Therefore, a pregnancy wish alone should not be a reason to exclude women for LKD.</p

Chocolate brownies and calorie restriction:the sweetest paradox?

Could sharing chocolate cake increase engagement with research on intermittent fasting? C A J Oudmaijer and colleagues investigat

Chocolate brownies and calorie restriction:the sweetest paradox?

Could sharing chocolate cake increase engagement with research on intermittent fasting? C A J Oudmaijer and colleagues investigat

Fasting before living-kidney donation: effect on donor well-being and postoperative recovery: study protocol of a multicenter randomized controlled trial

Background: One of the main effectors on the quality of life of living-kidney donors is postoperative fatigue. Caloric restriction (CR) and short-term fasting (STF) are associated with improved fitness and increased resistance to acute stress. CR/STF increases the expression of cytoprotective genes, increases immunomodulation via increased anti-inflammatory cytokine production, and decreases the expression of pro-inflammatory markers. As such, nutritional preconditioning by CR or STF represents a non-invasive and cost-effective method that could mitigate the effects of acute surgery-induced stress and postoperative fatigue. To investigate whether preoperative STF contributes to a reduction in fatigue after living-kidney donation, a randomized clinical trial is indicated. Methods: We aim to determine whether 2.5 days of fasting reduces postoperative fatigue score in subjects undergoing living-kidney donation. In this randomized study, the intervention group will follow a preoperative fasting regime for 2.5 days with a low-dose laxative, while the control group will receive standard care. The main study endpoint is postoperative fatigue, 4 weeks after living-kidney donation. Secondary endpoints include the effect of preoperative fasting on postoperative hospital admission time, the feasibility of STF, and the postoperative recovery of donor and recipient kidney function. This study will provide us with knowledge of the feasibility of STF and confirm its effect on postoperative recovery. Discussion: Our study will provide clinically relevant information on the merits of caloric restriction for living-kidney donors and recipients. We expect to reduce the postoperative fatigue in living-kidney donors and improve the postoperative recovery of living-kidney recipients. It will provide evidence on the clinical merits and potential caveats of preoperative dietary interventions. Trial registration: Netherlands Trial Register NL9262. EudraCT 2020-005445-16. MEC Erasmus MC MEC-2020-0778. CCMO NL74623.078.21