Gebretsadik Gebretsadkan Gebremedhin, Mengistu Zelalem Debebe, Molla Birhanu Worku, Desta Helen Tkuwab
1Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
2Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Nutr. 2020 Apr 9;6:14. doi: 10.1186/s40795-020-00333-y. eCollection 2020.
Nutrition and dietary patterns are modifiable factors that can be utilized to prevent or slow the progression of Chronic kidney disease (CKD). Adherence to current dietary recommendations can reduce the incidence, or slow the progression of CKD and reduce mortality. The objectives of this study was to compare the dietary nutrient intake of CKD patients (CKD above stage 3 including hemodialysis) to dietary recommendations and to assess the correlations of those dietary nutrient intakes with each other and with chosen laboratory measurements.
A hospital-based cross-sectional study was conducted among 100 patients with CKD. A consecutive 7 days dietary record supplemented with interviews for data completion was used to assess dietary intake. Recent clinical laboratory measurements were obtained from patients' medical records. The obtained dietary data were analyzed by the Ethiopian food composition database and the nutrisurvey software. Dietary energy and nutrients intake were compared with recommendations for CKD patients.
The dietary energy intake (DEI) of almost all patients was below recommended levels. The average Dietary protein intake (DPI) was above the recommended levels (0.95 ± 0.27 g/kg/day) for about 60% of the respondents. Besides, 38% and only two of the respondents had their dietary phosphorus and potassium intakes above recommended levels, respectively. Estimated Glomerular filtration rate (eGFR) was positively correlated with both total and animal protein intakes while blood levels of creatinine and urea were negatively correlated with animal protein intake.
Patients with CKD are not well adhered to dietary recommendations and some nutrients showed correlation with chosen clinical laboratory measurements. Besides, DEI and DPI were below and above recommended levels, respectively, for most patients. Besides, more than one-third of the participants had phosphorus intakes above recommendation. These non-optimal dietary nutrient intakes may contribute to fast clinical deterioration and mortality.
营养和饮食模式是可改变的因素，可用于预防或减缓慢性肾脏病（CKD）的进展。遵循当前的饮食建议可降低CKD的发病率或减缓其进展，并降低死亡率。本研究的目的是比较CKD患者（3期以上CKD，包括血液透析患者）的膳食营养素摄入量与饮食建议，并评估这些膳食营养素摄入量之间以及与所选实验室测量值之间的相关性。
对100例CKD患者进行了一项基于医院的横断面研究。采用连续7天的饮食记录并辅以访谈以完成数据收集，来评估饮食摄入量。从患者的病历中获取近期临床实验室测量值。所获得的饮食数据通过埃塞俄比亚食物成分数据库和营养调查软件进行分析。将膳食能量和营养素摄入量与CKD患者的建议摄入量进行比较。
几乎所有患者的膳食能量摄入量（DEI）均低于推荐水平。约60%的受访者的平均膳食蛋白质摄入量（DPI）高于推荐水平（0.95±0.27 g/kg/天）。此外，分别有38%的受访者和仅两名受访者的膳食磷和钾摄入量高于推荐水平。估算的肾小球滤过率（eGFR）与总蛋白和动物蛋白摄入量均呈正相关，而血肌酐和尿素水平与动物蛋白摄入量呈负相关。
CKD患者未很好地遵循饮食建议，一些营养素与所选临床实验室测量值显示出相关性。此外，大多数患者的DEI低于推荐水平，而DPI高于推荐水平。此外，超过三分之一的参与者的磷摄入量高于推荐值。这些非最佳的膳食营养素摄入量可能会导致临床快速恶化和死亡。
