Chronic Kidney Disease Clinical Trial
Official title:
Effects of the 6-point Diet on the Metabolic Control, the Compliance and the Nutritional Status of CKD Patients Stage 3b-5
The dietary restriction of proteins and sodium is a cornerstone in the treatment of chronic
kidney disease (CKD) and of its metabolic consequences. Dietary adjustments in CKD are
complex and the patients' compliance is very low. A dietary interview method is a validated
instrument to evaluate the patients' compliance; however, it the presence of a dedicated
dietitians. For these reasons, and because of the absence of dedicated dietitians in many
nephrology centres, it is usual practice to give standard low protein diets to CKD patients
not on dialysis.
Aim of this study was to verify if few simple tips were able to reduce protein, phosphate
and sodium intake in patients with CKD, as compared to the practice of giving a low protein
diet elaborated by a renal dietitian.
The dietary restriction of proteins and sodium is a cornerstone in the treatment of chronic
kidney disease (CKD) and of its metabolic consequences. In fact, a reduced protein intake
decreases load on remaining nephrons, reduces signs and symptoms of uraemia, lessens the
accumulation of waste metabolic products and oxidant stress, improves insulin-resistance and
lipid profile, ameliorates proteinuria, additives effects of angiotensin-converting-enzyme
inhibitors, and decreases likelihood of patients death or delays initiation of dialysis by
40%.
Dietary adjustments in subjects with chronic renal failure are complex because multiple
nutrient modifications are required and changes in lifestyle must be maintained for years.
Furthermore, low-protein diet is considered tedious, unpalatable and difficult to achieve.
This has an obvious negative influence on the quality of life of patients and makes their
adherence to the new therapeutic prescriptions more difficult. In fact, the difficulty to
reach patients' compliance is well known. There is ample evidence that poor adherence is
considered a critical barrier to treatment success and remains one of the leading challenges
to healthcare professionals. Few data are available in clinical practice concerning the
patients' compliance to low protein diet. A dietary interview method is a validated
instrument to evaluate the practice and routines related to the assessment of nutrient
intake in nondialyzed CKD patients and to obtain the patients' compliance. However, the
interview requires the presence of a dedicated dietitian and a lot of his time.
For these reasons, and because of the absence of dedicated dietitians in many nephrology
centres, it is usual practice to give standard low protein diets to CKD patients not on
dialysis.
Aim of this study was to verify if few simple tips were able to reduce protein, phosphate
and sodium intake in patients with CKD, as compared to the practice of giving a low protein
diet elaborated by a renal dietitian.
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Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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