Furthermore, the optimal delivery

methods for engraftment, long-term safety and their ability to modify the tissue microenvironment in a setting of fibrosis require additional consideration. “
“Date written: June 2008 Final submission: June 2009 No recommendations possible based on Level I or II evidence. (Suggestions are based on Level III and IV evidence) Once graft is functioning: A diet rich in wholegrain, low glycaemic index and high fibre carbohydrates see more as well as rich sources of vitamin E and monounsaturated fat should be recommended to adult kidney transplant recipients with elevated serum total cholesterol, LDL-cholesterol and triglycerides. (Level III–IV) Carbohydrate should be consumed predominantly in the form of wholegrains

and foods with a low energy density and/or low glycaemic index, aiming for a daily fibre intake of 25 g for females and 30 g for males. The inclusion of the soluble fibre beta-glucan should be encouraged as it has been shown to lower LDL-cholesterol in non-transplant populations.1–4 Total fat should contribute 30–35% of total energy intake. Saturated and trans fatty acids together should contribute no more than 8% of total energy intake. n-6 polyunsaturated fat should contribute 8–10% of total energy. Monounsaturated fat may contribute up to 20% of total energy intake. n-3 polyunsaturated fat should be included in the diet as both plant and marine sources.1,2,5 Include plant foods which are naturally

NVP-BKM120 rich in phytosterols as well as 2–3 g phytosterol-enriched food products (such as margarine, breakfast cereal, low fat yoghurt or milk enriched with phytosterols. Australian regulations allow a minimum of 0.8 g and a maximum of 1.0 g phytosterols per serve of food, thus two or three serves of phytosterol-fortified foods should be recommended.6,7 Dyslipidaemia is common after renal transplantation, estimated to be present in around 60% of kidney transplant recipients. The definition of dyslipidaemia which has been adopted by the National Kidney Foundation KDOQI,10 based on that of the Adult Treatment Panel III,11 is the presence of one or more of the following: total serum cholesterol >200 mg/dL; LDL-cholesterol >130 mg/dL; triglycerides >150 mg/dL; HDL-cholesterol <40 mg/dL. The typical lipid profile of transplant recipients Org 27569 includes elevated total serum cholesterol and low-density lipoprotein cholesterol (LDL-C), with variable high-density lipoprotein cholesterol (HDL-C) and triglycerides.12–15 Studies have shown that lipoprotein abnormalities are a persistent problem even 10 years post-transplant.16,17 The correlation between dyslipidaemia and cardiovascular disease (CVD) risk in non-transplant populations has been well established.11 Several studies have reported a positive association between total cholesterol and atherosclerotic CVD in kidney transplant recipients, similar to that observed in the general population.