Ekbote Apeksha, Ghosh-Jerath Suparna, Sharma Vidisha, Subbaiyan Suresh Sankara, Shah Kamal D, Joshi Vidya Rajesh, Ankush Ganesh Rameshwar, Sharma Shruti, Kasiviswanathan Savitha
NephroPlus Dialysis Center, Hyderabad, Telangana, India.
The George Institute for Global Health, New Delhi, India.
Indian J Nephrol. 2024 Sep-Oct;34(5):493-500. doi: 10.25259/ijn_562_23. Epub 2024 Jun 29.
Malnutrition and suboptimal food intake are common concerns among chronic kidney disease (CKD) patients. Medical nutrition therapy plays a significant role in ensuring the well-being of CKD patients undergoing maintenance hemodialysis (MHD). The present study explored the dietary intake and quality of life (QOL) of CKD patients on MHD.
Adult CKD patients (n = 107, >20 years, 72% male) on MHD were conveniently selected from dialysis centers across India. This cross-sectional exploratory study elicited information on general profile, height, dry body weight, biochemical parameters, food intake, and QOL of the patients. Nutrient intake was compared with Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines.
The average energy and protein intake per kg body weight was below the recommendations (energy ∼21 kcal/kg vs. 30-35 kcal/kg body weight and protein ∼0.7g/kg vs. 1-1.2 g/kg body weight). Majority of them (>75%) had inadequate energy and protein intake. The sodium intake of the participants (3109.42 ± 1012.31 mg) was higher than the suggested limit. The energy and protein intake/kg ideal body weight of female patients was significantly higher than male patients (p < 0.05). Overall, their QOL was satisfactory. However, nearly half of them (47%) reported moderate-level problem in the pain and discomfort dimension.
Patients were not meeting the recommendations especially for energy and protein. Patient-specific customized nutrition counseling along with routine nutrition assessment, follow-up of patients and continued nutrition education, and motivation and support from the medical care team, especially the dietitian is needed for better dietary compliance and overall improvement of QOL.
营养不良和食物摄入不足是慢性肾脏病(CKD)患者常见的问题。医学营养治疗在确保接受维持性血液透析(MHD)的CKD患者的健康方面发挥着重要作用。本研究探讨了接受MHD的CKD患者的饮食摄入量和生活质量(QOL)。
从印度各地的透析中心方便地选取了成年MHD患者(n = 107,年龄>20岁,72%为男性)。这项横断面探索性研究收集了患者的一般情况、身高、干体重、生化参数、食物摄入量和生活质量等信息。将营养摄入量与肾脏病预后质量倡议(KDOQI)指南进行了比较。
每公斤体重的平均能量和蛋白质摄入量低于推荐值(能量约21千卡/公斤,而推荐为30 - 35千卡/公斤体重;蛋白质约0.7克/公斤,而推荐为1 - 1.2克/公斤体重)。大多数患者(>75%)能量和蛋白质摄入不足。参与者的钠摄入量(3109.42 ± 1012.31毫克)高于建议限值。女性患者每公斤理想体重的能量和蛋白质摄入量显著高于男性患者(p < 0.05)。总体而言,他们的生活质量令人满意。然而,近一半(47%)的患者在疼痛和不适维度报告有中度问题。
患者未达到推荐标准,尤其是在能量和蛋白质方面。需要针对患者的定制营养咨询,以及常规营养评估、患者随访、持续营养教育,并且需要医疗团队,尤其是营养师的激励和支持,以实现更好的饮食依从性和生活质量的全面改善。