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

被引：7

作者：

Oudmaijer, C. A. J. ^{[1
,2
,3
]}

Minnee, R. C. ^{[1
]}

Pol, R. A. ^{[4
]}

van den Boogaard, W. M. C. ^{[2
,3
]}

Komninos, D. S. J. ^{[2
,3
]}

van de Wetering, J. ^{[5
]}

van Heugten, M. H. ^{[5
]}

Hoorn, E. J. ^{[5
]}

Sanders, J. S. F. ^{[6
]}

Hoeijmakers, J. H. J. ^{[2
,3
,7
,8
,9
]}

Vermeij, W. P. ^{[2
,3
]}

IJzermans, J. N. M. ^{[1
]}

机构：

[1] Erasmus MC, Erasmus MC Transplant Inst, Dept Surg, Div Hepatobiliary & Transplantat Surg, Dr Molewaterpl 40,RG-220, NL-3015 GD Rotterdam, Netherlands

[2] Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands

[3] Oncode Inst, Utrecht, Netherlands

[4] Univ Med Ctr Groningen, Dept Transplantat Surg, Groningen, Netherlands

[5] Erasmus MC, Div Nephrol & Transplantat, Dept Internal Med, Rotterdam, Netherlands

[6] Univ Med Ctr Groningen, Div Nephrol & Transplantat, Dept Internal Med, Groningen, Netherlands

[7] Erasmus MC, Erasmus MC Canc Inst, Dept Mol Genet, Rotterdam, Netherlands

[8] Univ Cologne, Inst Genome Stabil Ageing & Dis, Fac Med, Cologne, Germany

[9] Univ Cologne, Ctr Mol Med Cologne CMMC, Cologne Excellence Cluster Cellular Stress Respon, Cologne, Germany

来源：

TRIALS | 2022年 / 23卷 / 01期

基金：

欧洲研究理事会;

关键词：

Fasting; Living-kidney donation; Postoperative recovery; lschemia-reperfusion injury; TERM DIETARY RESTRICTION; QUALITY-OF-LIFE; ISCHEMIA-REPERFUSION; ENHANCED RECOVERY; CALORIC RESTRICTION; COLORECTAL SURGERY; INJURY; STRESS;

D O I：

10.1186/s13063-021-05950-x

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

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.

引用

页数：10

共 47 条

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