Morris Andrew, Lycett Deborah
Faculty of Health and Life Sciences, Coventry University, Coventry, UK; Renal Department, University Hospital, Coventry, UK.
Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
J Ren Nutr. 2020 Nov;30(6):556-560. doi: 10.1053/j.jrn.2020.01.025. Epub 2020 Apr 6.
Dietary potassium restrictions in kidney disease are complex to follow and may reduce quality of life. However, details on this impact are sparse. We therefore sought to explore patients' perspectives on the experienced impact of following low-potassium diets, to inform clinical practice and research.
Qualitative semistructured interviews were undertaken in a UK teaching hospital with adults undergoing maintenance hemodialysis. Audio-recorded, transcribed interviews underwent thematic analysis.
34 adults (19 women, 15 men, and mean age 66.7 ± 10.9 years) with chronic kidney disease (CKD) participated. Our analysis identified three themes with subthemes: "What is left for me to eat now?"; "I'm obviously different"; "Food can be socially awkward", and one outlying theme: "Money doesn't grow on trees." Practical difficulties experienced when coming to terms with dietary restrictions meant testing out advice and experimenting with low- and high-potassium foods, to find a reasonable compromise, despite worries they could die from eating too much potassium. Interactions with food providers were dependent on pre-existing relationships, and maintaining these, at the expense of their dietary needs. Obtaining dietary requirements in restaurants often resulted in conflict with less concern for maintaining a relationship with those in the restaurant. Some individuals experienced financial difficulties, and decisions were made to prioritize family needs over their own dietary requirements.
Low-potassium diets bring practical and psychosocial consequences which significantly impacts people living with CKD. Renal health professionals should offer more support to people on a low-potassium diet. Public education on dietary potassium requirements in CKD, particularly in the food service industry to increase awareness, may be a worthwhile intervention.
肾病患者遵循饮食钾限制很复杂，且可能降低生活质量。然而，关于这种影响的细节却很少。因此，我们试图探究患者对遵循低钾饮食所体验到的影响的看法，以为临床实践和研究提供信息。
在一家英国教学医院对接受维持性血液透析的成年人进行了定性半结构化访谈。对录音并转录的访谈进行了主题分析。
34名患有慢性肾脏病（CKD）的成年人（19名女性，15名男性，平均年龄66.7±10.9岁）参与了研究。我们的分析确定了三个主题及子主题：“现在我还能吃什么？”；“我明显与众不同”；“食物在社交场合可能会尴尬”，以及一个外围主题：“钱不是从天上掉下来的”。在接受饮食限制时遇到的实际困难意味着要试验建议并尝试低钾和高钾食物，以找到合理的折衷办法，尽管担心会因摄入过多钾而死亡。与食物提供者的互动取决于先前存在的关系，并以牺牲他们的饮食需求为代价来维持这些关系。在餐馆获取饮食需求往往会导致冲突，而对与餐馆人员维持关系的关注较少。一些人经历了经济困难，并决定将家庭需求置于自身饮食需求之上。
低钾饮食会带来实际和心理社会后果，对慢性肾脏病患者产生重大影响。肾脏健康专业人员应为低钾饮食的人提供更多支持。对慢性肾脏病患者的饮食钾需求进行公众教育，特别是在食品服务业提高认识，可能是一项值得进行的干预措施。
