Betz Melanie V, Nemec Kelly B, Zisman Anna L
Chronic Kidney Disease Nutrition & Education Specialist, Section of Nephrology, University of Chicago Medicine, Chicago, IL.
Transplant Dietitian II, Transplant Surgery, University of Chicago Medicine, Chicago, IL.
J Ren Nutr. 2022 Sep;32(5):552-559. doi: 10.1053/j.jrn.2021.09.008. Epub 2021 Nov 12.
Plant-based diets can delay the progression of chronic kidney disease (CKD) and help manage complications and co-morbid conditions such as hypertension, acidosis, diabetes, and cardiovascular disease. However, it is unclear how often plant-based diets are recommended to patients with kidney disease. The objective of this study was to understand nephrology professionals' familiarity, perception, and recommendation of plant-based diets to people with kidney disease.
A survey to understand perception of recommendation of plant-based diets for patients with CKD was developed. Nephrology professionals from the National Kidney Foundation's member directory were e-mailed a link to complete the survey online. This directory includes professionals who work in a variety of nephrology settings, including both CKD and end-stage renal disease care. Survey items were evaluated with descriptive statistics. Differences across items were determined using chi-square tests and t-tests.
A total of 3,901 professionals were sent the survey, and 644 completed the survey. A majority were dietitians (58%) and worked in dialysis clinics (54%). Most (88%) had heard of using plant-based diets for kidney disease treatment, and a majority (88%) believed it could improve CKD management, cardiovascular disease (90%), hypertension (90%), diabetes (84%), high cholesterol (90%), and obesity (84%). Dietitians were more likely to report plant-based diets as beneficial for each health condition (P < .05). Professionals were most confident that a plant-based diet could help control hypertension (3.75 ± 0.99 on a scale of 1-5), compared with delaying progression of CKD (3.68 ± 1.15) or treating acidosis (3.68 ± 1.13). Dietitians felt more confident in their ability to plan a balanced plant-based diet compared with other specialties (3.49 vs. 2.74, P < .001).
Nephrology professionals who work in nondialysis-dependent CKD settings, and those who work with patients on dialysis, are aware of the benefits of plant-based diets in kidney disease. However, plant-based diets are not routinely being offered as a treatment option. Nephrology practices should work to increase dietitian referrals to offer patients support in transitioning to a plant-based diet.
以植物为基础的饮食可以延缓慢性肾脏病(CKD)的进展,并有助于控制并发症和合并症,如高血压、酸中毒、糖尿病和心血管疾病。然而,目前尚不清楚向肾病患者推荐以植物为基础的饮食的频率。本研究的目的是了解肾脏病专业人员对以植物为基础的饮食的熟悉程度、看法以及向肾病患者的推荐情况。
开展了一项调查,以了解对CKD患者推荐以植物为基础的饮食的看法。通过电子邮件向美国国家肾脏基金会成员名录中的肾脏病专业人员发送了一个在线完成调查的链接。该名录包括在各种肾脏病环境中工作的专业人员,包括CKD和终末期肾病护理。调查项目采用描述性统计进行评估。使用卡方检验和t检验确定各项目之间的差异。
共向3901名专业人员发送了调查问卷,644人完成了调查。大多数是营养师(58%),在透析诊所工作(54%)。大多数人(88%)听说过使用以植物为基础的饮食治疗肾病,大多数人(88%)认为它可以改善CKD管理、心血管疾病(90%)、高血压(90%)、糖尿病(84%)、高胆固醇(90%)和肥胖(84%)。营养师更有可能报告以植物为基础的饮食对每种健康状况都有益(P <.05)。与延缓CKD进展(3.68±1.15)或治疗酸中毒(3.68±1.13)相比,专业人员最确信以植物为基础的饮食有助于控制高血压(在1-5分的量表上为3.75±0.99)。与其他专业相比(3.49对2.74,P <.001),营养师对制定均衡的以植物为基础的饮食的能力更有信心。
在非透析依赖的CKD环境中工作的肾脏病专业人员以及与透析患者一起工作的人员,都意识到以植物为基础的饮食对肾病的益处。然而,以植物为基础的饮食并未作为一种常规的治疗选择提供。肾脏病医疗实践应努力增加营养师的转诊,为患者提供支持,帮助他们过渡到以植物为基础的饮食。