Oxidative stress after kidney transplantation: Consequences and dietary opportunities

Kidney transplantation is the primary treatment for kidney failure. Yet, there's a persistent need to improve long-term outcomes, particularly in extending graft survival and reducing cardiovascular mortality among kidney transplant recipients (KTR).
Oxidative stress, characterized by an imbalance between reactive oxygen species (ROS) generation and the body's antioxidant defences, is implicated in poor post-transplant outcomes. This thesis explores its association with long-term graft failure and cardiovascular mortality in KTR.
In Chapter 1, our results suggest that heightened urinary copper, which is an oxidative element, is linked to increased risk of graft failure, especially in KTR with proteinuria. Chapter 2 introduces urinary liver-type fatty acid binding protein (u-LFABP) as a potential tool to predict KTR at higher risk for graft failure.
Chapters 3 and 4 delve into oxidative stress's impact on cardiovascular mortality. Elevated levels of the oxidative stress biomarker malondialdehyde (MDA) and plasma copper correlate with increased cardiovascular risk in KTR.
In chapters 5 and 6, this thesis explores dietary interventions as a potential tool to mitigate oxidative stress. Higher selenium intake, contained especially in fish and meat, is associated with reduced mortality risk in KTR. Vitamin C deficiency was frequent among KTR, especially patients with diabetes and smokers. Fruit intake was associated with lower deficiency risk.
Overall, the thesis underscores oxidative stress's role in post-transplant complications and highlights dietary modifications as potential interventions to improve long-term outcomes in KTR. Further research is needed to develop reliable oxidative stress assays and tailor dietary recommendations in KTR.