Individualized nutrition counseling found effective for patients with CKD
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Patients who received 3 months of individualized nutritional counseling reaped a variety of benefits, including better adherence to dietary recommendations, decreased BMI and improved kidney function.
“In spite of the reported benefits of intensive individualized nutrition counseling for advanced CKD patients, insurance policies for such intervention are still limited in several countries, including Korea,” Hosun Lee, CCD, MS, of the department of nutrition care at Severance Hospital, Yonsei University Health System, and colleagues wrote. “Dietary patterns depend deeply on ethnicity and cultural background. For instance, the typical Asian diet is composed of less protein and more [sodium] Na. Therefore, the effect of nutrition counseling would also vary depending on the region and culture.”
Contending that most studies on nutrition counseling have been focused on Western countries, the researchers here studied its impact on “a single nation Asian ethnic group,” recruiting 59 patients with stage 3 and 4 CKD from a tertiary hospital outpatient clinic in Korea (81% were men).
Patients were randomized to an intensive care group or a control group. While all patients first received one 45-minute group session regarding nutritional information, diet management practices to prevent complications, and meal plans, those in the intervention received 3 monthly sessions of individualized intensive nutrition counseling.
“For intensive individualized nutrition counseling, a trained clinical dietitian calculated each patient’s nutritional requirements according to ideal body weights based on the [Kidney disease: Improving Global Outcomes] KDIGO guidelines,” the researchers wrote.
In addition, patients in the individualized counseling group kept food diaries and were provided tailored nutritional information.
The most common nutritional diagnoses were excessive intake of sodium (97.6%), potassium (78.6%), protein (52.4%) and phosphorus (31%).
After 3 months of counseling, Lee and colleagues observed that while potassium and phosphorous intakes decreased significantly in both groups, protein, sodium and energy intakes only decreased in the intensive group.
Further findings indicated BMI decreased and eGFR improved for patients in the intensive group but not the control group.
“Although dietary modification is a critical component of CKD management, patients’ compliance is still far from satisfactory,” Lee and colleagues concluded.
“It should be noted that multiple intensive nutrition counseling sessions, although provided for only 3 months, resulted in improved dietary adherence and clinical improvement in CKD patients.”
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