Assessment of food consumption in patients with chronic kidney disease after nutritional counseling
DOI:
https://doi.org/10.12957/demetra.2022.62874Keywords:
Diet, Food and Nutrition. Diet Therapy. Chronic Kidney Failure.Abstract
Introduction: Nutritional counseling is a key component in treating chronic kidney disease (CKD). Adequate caloric intake helps in reducing sodium, protein, fluid, and electrolytes in the diet and prevents further complications of the disease. Thus, this study aimed to evaluate the effect of nutritional counseling on patients with non-dialysis CKD. Methods: A quasi-experimental, controlled study with individuals in stages 3 and 4 of the disease, divided into two groups: control and counseling composed of individuals without nutritional counseling followed for 90 days. Anthropometry and clinical and nutritional assessment data were collected through the application of a 24-hour recall (R24h). Food consumption assessment was obtained using the Nutrition Data System for Research (NDSR) program. Data analysis was performed using a repeated measures model evaluating the interaction between groups versus moments. The 95% significant level was fixed for all tests. Results: 51 patients were included, 24 controls, and 27 counselings. Initial analysis showed that the groups were homogeneous. The assessment of food consumption after the counseling, with guidelines for healthy eating, resulted in a favorable response to protein control, and mineral restrictions: phosphorus, sodium, and potassium. Lower intake of calcium and vitamin D was not observed, factor that could worsen changes in bone and mineral metabolism, and there were no adverse effects on anthropometry. Conclusion: Nutritional counseling is effective, and provides adequate food consumption to the recommendations proposed in CKD.
References
Webster A, Nagler E, Morton R, Marsson P. Chronic kidney disease. Lancet 2017; 389: 1238-52, DOI: https://doi.org/10.1016/S0140-6736(16)32064-5.
National Kidney Foundation. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020; 76(3) (suppl 1):S1-107, DOI: https://doi.org/10.1053/j.ajkd.2020.05.006.
Levey A, Eckardt K, Dorman N, Christiansen S, Hoorn E, Ingelfinger J, et al. Nomenclature for kidney function and disease: report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference. Kidney Int. 2020; 95(6): 1117-29, DOI: https://doi.org/ 10.1016/j.kint.2020.02.010.
Raji Y, Mabayoje M, Bello B, Amira C. Albuminuria and Reduced Estimated Glomerular Filtration Rate among First-degree Relatives of Patients with Chronic Kidney Disease in Lagos, Southwest Nigeria. Indian J. Nephrol. 2018; 28(3):21-7, DOI: https://doi.org/ 10.4103/ijn.IJN_225_16.
Flahault A, Chassé J, Thervet E, Karras A, Pallet N. Relevance of urinary specific protein assay in the diagnosis of kidney diseases. Ann. Biol. Clin. (Paris) 2018; 76(3):259-69, DOI: https://doi.org/ 10.1684/abc.2018.1343.
Iseki K, Konta T, Asahi K, Yamagata K, Fujimoto S. Dipstick proteinuria and all-cause mortality among the general population. Clin. Exp. Nephrol. 2018; 22(6):1331-40, DOI: https://doi.org/ 10.1007/s10157-018-1587-x.
Koppe L. & Fouque D. The role for protein restriction in addition to renin-angiotensin-aldosterone system inhibitors in the management of CKD. A.J.K.D. 2019; 73(2):248-57, DOI: https://doi.org/ 10.1053/j.ajkd.2018.06.016.
Kalantar-Zadeh K. & Fouque D. Nutritional Management of Chronic Kidney Disease. N. Engl. J. Med. 2017; 377:1765-76, DOI: https://doi.org/ 10.1056/NEJMra1700312.
Chewcharat A, Takkavatakarn K, Wongrattanagorn S, Panrong K, Kittiskulnam P, Eiam-Ong S,et al. The Effects of Restricted Protein Diet Supplemented With Ketoanalogue on Renal Function, Blood Pressure, Nutritional Status, and Chronic Kidney Disease-Mineral and Bone Disorder in Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis. J. Ren. Nutr. 2020; 30 (3):189-99, DOI: https://doi.org/ 10.1053/j.jrn.2019.07.005.
Mozaffari H, Ajabshir S, Alizadeh S. Dietary Approaches to Stop Hypertension and risk of chronic kidney disease: A systematic review and meta-analysis of observational studies. Clin. Nutr. 2020; 39(7):2035-44, DOI: https://doi.org/ 10.1016/j.clnu.2019.10.004.
Ahn S, Kim D, Han S, Park J, Shin S, Lee S, et al. Weight loss has an additive effect on the proteinuria reduction of angiotensin II receptor blockers in hypertensive patients with chronic kidney disease. Kidney Res. Clin. Pract. 2018; 37:49-58, DOI: https://doi.org/ 10.23876/j.krcp.2018.37.1.49.
Jain N & Reilly R. Effects of dietary interventions on incidence and progression of CKD. Nat. Rev. Nephrol. 2014; 10: 712-24, DOI: https://doi.org/ 10.1038/nrneph.2014.192.
Kalantar-Zadeh K. & Li P. Strategies to prevent kidney disease and its progression. Nature Reviews Nephrol. 2020; 16:129-30, DOI: https://doi.org/ 10.1038/s41581-020-0253-1.
Notaras S, Galea L, Lee P, Mak M, Lambert K,et al. The association between dietetic consultation and time to dialysis for patients attending a pre-dialysis clinic: A retrospective cohort study. Nephol. 2020. 25(5):390-97, DOI: https://doi.org/ 10.1111/nep.13639.
Anderson C & Nguyen H. Nutrition education in the care of patients with chronic kidney disease and end-stage renal disease. Semin. Dial. 2018; 31(2):114-21 DOI: https://doi.org/ 10.1111/sdi.12681.
Fernandes A, Ramos C, Nerbass F, Cuppari L. Diet Quality of Chronic Kidney Disease Patients and the Impact of Nutritional Counseling. J. Ren. Nutr. 2018; 28(6):403-410, DOI: https://doi.org/ 10.1053/j.jrn.2017.10.005.
Fisberg R. Avaliação do consumo alimentar e da ingestão de nutrientes na prática clínica. Arq. Bras. Endocrinol. Metab. 2009; 53-55, DOI: https://doi.org/10.1590/S0004-27302009000500014.
Bellizzi V, Calella P, Hernández J, González V, Lira S. Safety and effectiveness of low-protein diet supplemented with ketoacids in diabetic patients with chronic kidney disease. B.M.C. Nephrol. 2018; 19(1):110, DOI: https://doi.org/ 10.1186/s12882-018-0914-5.
Machado A, Anjos F, Domingos M, Molina M, Marchioni D, Bensenor I, et al. Dietary intake of non-dialysis chronic kidney disease patients: the PROGREDIR study. A cross-sectional study. São Paulo Med. J. 2018; 136(3):208-15, DOI: https://doi.org/ 10.1590/1516-3180.2017.0177141217.
Organización Panamericana De La Salud. División De Promoción Y Protección De La Salud (Hpp-). Encuesta Multicentrica salud beinestar y envejecimiento (SABE) em América Latina el Caribe: Informe Preliminar [Internet]. In: XXXVI Reunión del Comité asesor de investigaciones em Salud; 9-11 jun 2001; Kingston, Jamaica: OPAS, 2002, available at <https://www1.paho.org/Spanish/HDP/HDR/CAIS-01-05.PDF>. Accessed on August 20, 2021.
World Health Organization. Encuesta multicêntrica: salud, bien estar y envejecimiento (SABE) em America Latina y el Caribe. In: Reunión Del Comité Asesor De Investigaciones Em Salud. Washington. Anales da 36ª Reunión Del Comité Asesor de Investigaciones en salud. Washington, 2001, available at: <https://www.opas.org/program/sabe.htm. >. Accessed on February 4, 2020.
Cuppari L. Nutrição clinica no adulto. Barueri: Manole; 2019.
Windahl K, Irving G, Almquist T, Lidén M, Luijtgaarden M, Chesnaye C, et al. Prevalence and risk of protein-energy wasting assessed by subjective global assessment in older adults with advanced chronic kidney disease: results from the EQUAL study. J. Renal Nut. 2018; 28(3):165-74, DOI: https://doi.org/ 10.1053/j.jrn.2017.11.002.
Rhee C. The dual roles of obesity in chronic kidney disease: a review of the current literature. Curr. Opin. Nephrol. Hypertens. 2016; 25(3):208-16, DOI: https://doi.org/ 10.1097/MNH.0000000000000212.
Kalantar-Zadeh K, Rhee C, Amin A. To legitimize the contentious obesity paradox. Mayo Clin. Proc. 2014; 89:1033-35, DOI: https://doi.org/ 10.1016/j.mayocp.2014.06.015.
Ziolkowski S, Long J, Baker J, Chertow G, Leonard M. Chronic Kidney Disease and the adiposity paradox: valid or confounded? J. Ren. Nut .2019; 29(6):521-28, DOI: https://doi.org/ 10.1053/j.jrn.2018.11.011.
Kovesdy C, Anderson J, Kalantar-Zadeh K. Paradoxical association between body mass index and mortality in men with CKD not yet on dialysis. Am. J. Kidney Dis. 2007; 49(5):581-91, DOI: https://doi.org/ 10.1053/j.ajkd.2007.02.277.
Walther C, Chandra A, Navaneethan S. Blood pressure parameters and morbid and mortal outcomes in nondialysis-dependent chronic kidney disease. Curr. Opin. Nephrol. Hypertens. 2018; 27(1):16-22, DOI: https://doi.org/ 10.1097/MNH.0000000000000375.
Saran R, Padilla R, Gillespie B, Heung M, Hummel S, Derebail V, et al. A Randomized Crossover Trial of Dietary Sodium Restriction in Stage 3-4 CKD. Clin. J. Am. Soc. Nephrol. 2017; 12(3):399-407, DOI: https://doi.org/ 10.2215/CJN.01120216.
Zha Y. & Qian Q. Protein Nutrition and Malnutrition in CKD and ESRD. Nutrients. 2017; 9(3):208, DOI: https://doi.org/ 10.3390/nu9030208.
Garibotto G, Picciotto D, Saio M, Esposito P, Verzola D. Muscle protein turnover and low-protein diets in patients with chronic kigney disease. Nephrol. Dial. Transplant. 2020; 35:741-51, DOI: https://doi.org/ 10.1093/ndt/gfaa072.
Kalantar-Zadeh K, Moore L, Tortorici A, Chou J, St-Jules D, et al. North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease. B.M.C. .Nephrol. 2016; 17(1):90, DOI: https://doi.org/ 10.1186/s12882-016-0304-9.
Hahn D, Hodson E, Fouque D. Low protein for non-diabetic adults with chronic kidney disease. Cochrane Database Syst. Rev. 2018; 10(10):CD001892, DOI: https://doi.org/ 10.1002/14651858.CD001892.pub4.
Chauveau P, Koppe P, Combe C, Lasseur C, Trolonge S, Aparicio M. Vegetarian diets and chronic kidney disease. Nephrol. Dial. Transplant. 2019; 34: 199-207, DOI: https://doi.org/ 10.1093/ndt/gfy164.
Mirmiran P, Yuzbashian E, Aghayan M, Mahdavi M, Asghari G, Azizi F. A Prospective Study of Dietary Meat Intake and Risk of Incident Chronic Kidney Disease. J. Ren. Nutr. 2019; 30(2):111-18, DOI: https://doi.org/ 10.1053/j.jrn.2019.06.008.
Kelly J, Palmer S, Wai S, Ruospo M, Carrero J, Campbell K, et al. Healthy dietary patterns and risk of mortality and ESRD in CKD: a meta-analysis of cohort studies. Clin. J. Am. Soc. Nephrol. 2017; 12: 272-79, DOI: https://doi.org/ 10.2215/CJN.06190616.
Rebholz C, Crews D, Grams M, Steffen L, Levey A, Miller E, et al. DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. Am. J. Kidney Dis. 2016; 68(6):853-61, DOI: https://doi.org/ 10.1053/j.ajkd.2016.05.019.
Cupisti A, Brunori G, Iorio B, D'Alessandro C, Pasticci F, Cosola C, et al. Nutritional treatment of advanced CKD: twenty consensus statements. J. Nephrol. 2018; 31(4):457-73, DOI: https://doi.org/ 10.1007/s40620-018-0497-z.
Sociedade Brasileira De Nefrologia. II Diretrizes Brasileiras de Prática Clínica para o Distúrbio Mineral e Ósseo na DRC. J. Bras. Nefrol. 2016, available at < https://www.bjnephrology.org/en/article/diretrizes-brasileiras-de-pratica-clinica-para-o-disturbio-mineral-e-osseo-na-doenca-renal-cronica/>. Accessed on August 20, 2021.
Uribarri J & Oh M. The key to halting progression of CKD might be in the produce market, not in the pharmacy. Kidney Int. 2012; 81(1):7-9, DOI: https://doi.org/ 10.1038/ki.2011.331.
Ramos C, Gonzalwz-Ortiz A, Espinosa-Cuevas A, Avesani C, Carrero J, Cupari L. Does dietary potassium intake associate with hyperkalemia in patients with chronic kidney disease? Nephrol. Dial. Transplant. 2020; 1-9, DOI: https://doi.org/10.1093/ndt/gfaa232.
Wai S, Kelly J, Johnson D, Campbell K. Dietary patterns and clinical outcomes in chronic kidney disease: the CKD.QLD Nutrition Study. J. Ren. Nutr. 2017; 27:175-82, DOI: https://doi.org/10.1053/j.jrn.2016.10.005.
Chan M, Kelly J, Tapsell L. Dietary Modeling of Foods for Advanced CKD Based on General Healthy Eating Guidelines: What Should Be on the Plate? Am. J. Kidney Dis. 2017; 69(3):436-50, DOI: https://doi.org/ 10.1053/j.ajkd.2016.09.025.
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