Martino Francesca K, Stefanelli Lucia F, Zattarin Alessandra, Lovato Correa Dias Larissa, Redi Greta, Khalf Rime, Del Prete Dorella, Nalesso Federico
Nephrology, Dialysis, Transplantation Unit, Department of Medicine (DIMED), University of Padova, 35128 Padua, Italy.
Department of Medicine (DIMED), Clinical Nutrition, University of Padua, 35128 Padua, Italy.
Nutrients. 2025 Apr 25;17(9):1438. doi: 10.3390/nu17091438.
BACKGROUND/OBJECTIVES: Educational support is a well-established strategy in diet management for chronic diseases. No study has reported the impact of protein counting in a low-protein diet for chronic kidney disease (CKD). We aimed to assess how a protein-counting educational program could enhance adherence and satisfaction in managing a low-protein diet in CKD patients with an eGFR below 20 mL/min/1.73 m.
We conducted a prospective pilot study comparing adherence and satisfaction before and after an educational program, which included four group meetings and two individual meetings over six months. Diet adherence was assessed by estimating protein intake using 24 h urine urea excretion, while diet satisfaction was evaluated with the MDRD questionnaire.
Twenty-four patients with a mean age of 63.9 years experienced improved diet adherence, with a significant reduction in protein intake (from 59.82 ± 15.57 g/day to 47.18 ± 13.7 g/day, < 0.001) and a significant increase in overall diet satisfaction (from a median of 3.57 (3.1-4) to 4 (3.6-4.1), = 0.001).
An educational program that includes protein counting assists CKD stage 4-5 patients in improving their diet adherence and increasing overall dietary satisfaction.
背景/目的：教育支持是慢性病饮食管理中一项成熟的策略。尚无研究报道蛋白质计数在慢性肾脏病（CKD）低蛋白饮食中的影响。我们旨在评估蛋白质计数教育计划如何提高估算肾小球滤过率（eGFR）低于20 mL/min/1.73 m²的CKD患者在低蛋白饮食管理中的依从性和满意度。
我们进行了一项前瞻性试点研究，比较了一项教育计划前后的依从性和满意度，该计划包括在六个月内举行的四次小组会议和两次个人会议。通过24小时尿尿素排泄量估算蛋白质摄入量来评估饮食依从性，同时使用肾脏病膳食改良试验（MDRD）问卷评估饮食满意度。
24名平均年龄为63.9岁的患者饮食依从性得到改善，蛋白质摄入量显著降低（从59.82±15.57克/天降至47.18±13.7克/天，<0.001），总体饮食满意度显著提高（从中位数3.57（3.1 - 4）提高到4（3.6 - 4.1），=0.001）。
包含蛋白质计数的教育计划有助于4 - 5期CKD患者提高饮食依从性并增加总体饮食满意度。
