Dietary restriction modifies certain aspects of the postoperative acute phase response.
van Ginhoven TM, Dik WA, et al.Journal of Surgical Research, 171(2): 582-589, 2011.
Aims
To determine whether or not the short-term dietary restriction in live kidney donors would reduce the acute phase response following a laparoscopic donor nephrectomy.
Interventions
30% preoperative dietary restriction followed by 1 day of fasting versus a 4 day ad libitum regimen prior to surgery.
Participants
30 live kidney donors.
Outcomes
C-reactive protein, number of leukocytes, level of cytokines including interleukin (IL)-1b, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, TNFa, and interferon-gamma (INF-g)]. Immunophenotyping included total number of B-cells (CD19+), T-cells (CD3+), CD3+/CD4+ T-cells, CD3+/CD8+ T-cells, natural killer cells (CD3-/CD16+/CD56+), and human leucocyte antigen-DR (HLA-DR) expression on T-cells (CD3+/HLA-DR).
Follow-up
4 days postoperation
CET Conclusions
The authors have carried out a small randomised controlled trial of dietary restriction compared to a normal nutritional intake in patients who are to have a laparoscopic donor nephrectomy. They claimed that dietary restriction does induce beneficial changes in the acute phase response following surgery. But the trial is of poor quality and the measured effects are modest. Much larger studies are required to validate the authors claims and then the question arises as to what benefit that would represent from a clinical point of view.
Data analysis
Per protocol analysis
Trial registration
NTR1875 (Dutch Trial Registry)