Variation of body fat percentage with special reference to diet modification in patients with chronic kidney disease: a longitudinal study.

Visceral adiposity causes hypertension, hyperglycemia and dyslipidemia. This study was conducted to evaluate whether a correlation exists between body fat percentage (BFP) of chronic kidney disease (CKD) patients and their dietary intake. In this hospital-based, quasi-experimental study, 135 incident cases of CKD were included, of whom 76 completed the study. The patients included were aged 18 years and above and had a body mass index (BMI) between 18 and 25 kg/m [2] , had CKD of any etiology and serum creatinine of up to 5 mg/dL. Patients with acquired immunodeficiency syndrome, active hepatitis B or C, malignancy, previous kidney transplantation, current participation in any trial, diabetes mellitus and those who were on dia-lysis were excluded. The study patients were put on a diet of 25-30 kcal/kg/day, with 60% of the calories coming from carbohydrates and 20% each from protein and fat. Assessment was made at baseline (BL) and at 12 months (TM) for anthropometric parameters, skin-fold thickness, nutritional parameters, serum albumin and dietary intake (3-day dietary record) and clinical characteristics. No significant change was seen in BFP, waist circumference (WC) and BMI at BS and at TM. There was significant improvement in serum albumin (P <0.05) and e-GFR (P <0.01) while CRP was elevated both at BL and TM. The dietary intake was within the prescribed limit, with significant improvement in energy intake between BS and TM (P <0.05). The intake of delta dietary protein and fat positively correlated with delta e-GFR (P <0.001). There was a significant association between change in BFP and change in BMI (P <0.005). During follow-up, there was no significant change in biochemical parameters and BFP as well as stage of CKD of the study patients. This study supports the fact that dietary counseling is an important part of treatment in patients with CKD.