Date of Award

12-2010

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Program

Nursing

Research Advisor

Ann K. Cashion, Ph.D.

Committee

Patricia A. Cowan, Ph.D. Ruth S. Tutor, Ph.D. Mona N. Wicks, Ph.D. Margaret R. Williams, Ed.D.

Abstract

Weight gain following kidney transplant is a significant problem with 50 to 90% of kidney transplant recipients gaining weight. Potential factors leading to weight gain following kidney transplantation have been thought to include a change in lifestyle such asdietary intake and physical activity, along with the use of immunosuppressant medications to preserve the newly implanted organ. Other influences affecting weight gain include genetic determinates such as age, gender and race. There is little data to confirm which of these factors may indeed lead to weight gain and obesity. The purpose of this study was to examine dietary intake and physical activity of kidney transplant recipients at baseline, 3 and 6 months following transplantation to identify contributing factors to weight gain.

Methods: This descriptive, correlational study included secondary data to examine dietary intake, physical activity and other variables (e.g., age, race, gender and medications) associated with weight gain post kidney transplant for 44 participants, 18 years or older. Three 24 dietary intake recalls (1 weekend day and 2 weekdays) and 7 day-physical activity recalls (7D-PAR) were collected at baseline, 3 months and 6 months post transplant. Nutrition Data System for Research (NDS-R), a Windows-based dietary analysis program, versions 2007, 2008 and 2009, (developed and coordinated by the Nutrition Coordinating Center, University of Minnesota, Minneapolis, Minnesota) was used to analyze dietary data. Weights were done at baseline, 3 and 6 months. Descriptive statistics and analysis of variance (ANOVA) for repeated measures were used to compare nutrient and physical activity changes. Pearsons’ product-moment correlation coefficient was used to describe the relationship of weight gain to other variables from baseline to 3 and 6 months.

Results: In the total sample, weight gain increased from 172.46 ± 34.05 to 182.09 ± 38.38 from baseline to 6 months, indicating a 6% increase in weight. Body Mass Index (BMI) increased by 5% from 26.40 ± 3.80 to 28.24 ± 4.17 from baseline to 6 months. By race and gender, African American (AA) males and females gained 11.1 and 11.7 pounds, respectively, while Caucasian males gained 9.3 pounds and Caucasian females gained 2.4 pounds. Dietary intake did not show statistical significance from baseline to 6 months. By race and gender, kilocalories (p ≤ 0.05), total fat (p ≤ 0.035) and total carbohydrate (p ≤ 0.048) intake was higher in males than females. African American females had higher intake of these nutrients than Caucasian females. Hours of sleep for the total sample was reported as (p ≤ 0.02), which showed a decrease in the number of hours from baseline to 6 months. Moderate activity (p ≤ 0.046) showed a decrease in males and increase in females at 6 months. Hours per day of hard activity (p ≤ 0.04) increased in Caucasian females at 6 months. No relationship was demonstrated among dietary intake, physical activity and age, race, gender and immunosuppression at 6 months.

Conclusion: Kidney transplant recipients are at risk for weight gain from a number of factors. Little consideration has been given to what kidney transplant recipients are eating and the effects of dietary intake on weight gain. Physical activity data from this study suggest that kidney transplant recipients are not changing their physical activity levels significantly by 6 months following transplantation. Further studies using a larger group should be considered.

DOI

10.21007/etd.cghs.2010.0061

Included in

Nursing Commons

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