Search Weight Loss Topics:




Apr 9

Patients with chronic kidney disease are not well adhered to dietary recommendations: a cross-sectional study – BMC Blogs Network

Diet Comments Off on Patients with chronic kidney disease are not well adhered to dietary recommendations: a cross-sectional study – BMC Blogs Network

The findings of this study confirmed that almost all respondents had their daily energy intakes below recommended levels (only 3 respondents fulfilled the recommendation). Similarly, in other studies, only two individuals met the daily dietary energy recommendations [10] and only 15% of patients reached 75% of their energy requirements [6]. Additionally, Shahar et al. found that the mean caloric intake (1683.9+/_546.9 kcal/day) for Haemodialysis (HD) patients deviated almost 20% below guidelines [13]. These similarities might be justified by the fact that all CKD patients have problems getting the right amount of dietary energy due to various factors including reduction in appetite.The average total protein intake in this presented research was 0.95g/kg of body weight. This is higher than the average DPI in another study in which it was 0.85g/kg of ideal body weight [10]. This may be reasoned out by the fact that the respondents in the later study were only predialysis patients, who usually limit their protein intake more than patients on dialysis.

Around 60% of the respondents in this study had their total protein intakes above recommended levels. This is a little bit different from a study done in Taiwan in which DPIs were significantly higher than the recommended levels in less than half of the respondents (47.2%) [14]. This variation could be because respondents in this presented research have never received counseling from a dietitian but a subset of those in the Chen et al., study received counseling from registered dietitians in the hospital they attend. Moreover, this difference can be attributed to the fact that protein intake goals set by the dietitians in the hospital, which were different from those set by National kidney foundation/Kidney disease outcomes quality initiative (NKF/KDOQI) intake goals, were used because the dietitians considered the patients current intake status.

About two-thirds (64%) of the analyzed respondents had animal protein intakes lower than the recommendations. However, it is recommended that greater than half of the protein intake should be of a high biologic value such as proteins in eggs, fish, poultry, meat, and dairy products because of the presence of essential amino acids [15]. Nevertheless, higher animal protein consumption, including red meat [16], is associated with rendering the kidneys to excrete a higher acid load as compared to higher dietary plant protein intake [17].

In this presented research, only two respondents had their daily dietary potassium intakes above recommendations. In a 5years cohort study, a higher dietary potassium intake was associated with increased death risk in HD patients, even after adjustments for other nutrient intakes [18]. Conversely, during earlier stages of CKD a diet high in potassium, which is usually low in sodium, may slow the progression of the disease by lowering blood pressure [19]. A small study suggested that the dietary approach to stop hypertension (DASH) diet may be a valuable, non-pharmacologic strategy for blood pressure control in individuals with CKD. However, this needs to be confirmed in larger sample size in order to be recommended [20].

In this presented study, respondents consuming less protein were simultaneously characterized by a lower intake of energy and most other nutrients. Similarly, in other research, CKD patients in highest baseline DPI and DEI quartiles had 4.11-fold (95% confidence interval: 2.796.05) higher odds of having protein energy wasting syndrome at month 12 [21]. These similarities may happen as a result of patients limiting the quantity of all consumed foods in an attempt to limit the level of protein in the diet. It is important that for HD patients an adequate energy intake is required to achieve positive nitrogen balance and individualized advice on suitable dietary sources of protein should be delivered by dietitian/nutrition advisors [11, 15].

Respondents with higher protein intake also had higher dietary phosphorus intake. Similarly, a review showed that there is a correlation between dietary intakes of protein and phosphorus [22]. In this study, however, DPI (or dietary phosphorus) was not correlated with serum phosphate levels. This is supported by another study which described that a high protein (and high phosphorus) diet does not always correlate with increased serum phosphate levels [23]. The difference in bioavailability of phosphorus from foods items may be the reason for this. Consuming a greater amount of protein from plants foods and reducing taking foods containing the inorganic phosphate which is readily absorbable and highly contributes to dietary phosphate load will be beneficial in the CKD population [24].

In this presented study, eGFR was significantly positively correlated with both total and animal protein intakes, but not with plant protein intake. Blood levels of creatinine and urea were also significantly negatively correlated with animal protein intake but not with total or plant protein intake. This is supported by other studies. A spontaneous decrease in energy and protein intake followed a decline in renal function in patients with no previous dietary intervention [7]. Similarly, patients with more advanced disease were characterized by significantly lower protein intake, which was associated with limiting animal protein [10]. These similarities in the findings imply the fact that patients reduce animal products, not plant products, which they think make a large source of protein. This may lead to a deficiency of essential amino acids and the risk of acquiring malnutrition. In contrast, other studies showed that lower energy and higher protein intakes than recommended levels may be associated with lowering renal function markers [14, 25] [26]. These studies mostly involved advanced CKD patients and support the current nutrition practice guidelines on providing adequate energy and optimal protein.

This study has some limitations. First, there may be a possibility of selection bias as the 100 study participants were selected purposely (non-random sampling). This was done in order to get an extensive dietary intake data (7days dietary record) from each patient. However, this might have created problems with the generalizability of the findings, though. Second, since data were collected at one point in time, this study cant show any cause and effect relationship between variables. In order to draw more reliable findings and conclusions, similar studies with stronger methodologies should be done in the future. Third, Dietary records might not provide an exact estimation of dietary nutrient intake. This is because respondents might have problems with accurately quantifying food portions and some might have changed their eating patterns which might distort the findings and lead to invalid conclusions. This limitation would be overcome if future researchers apply a more objective and stronger dietary intake assessment method to get accurate nutrient intake data and plausible findings.

View original post here:
Patients with chronic kidney disease are not well adhered to dietary recommendations: a cross-sectional study - BMC Blogs Network

Related Posts

    Your Full Name

    Your Email

    Your Phone Number

    Select your age (30+ only)

    Select Your US State

    Program Choice

    Confirm over 30 years old

    Yes

    Confirm that you resident in USA

    Yes

    This is a Serious Inquiry

    Yes

    Message:



    matomo tracker