Assessment of diet in chronic kidney disease female predialysis patients.

INTRODUCTION AND OBJECTIVE: Nutrition is important in the therapy of predialysis patients. The aim of the presented single-centre descriptive study was to assess the diet in chronic kidney disease female predialysis patients with no previous dietary intervention, in comparison with recommendations, as well as the analysis of the energy, protein and phosphate intake in correlation with chosen laboratory measurements. MATERIALS AND METHODS: The research was carried out in 31 female predialysis patients with CKD of different etiology, aged 29-79 years (GFR: 19.4±9.7 ml/min/1.73 m2). Main outcome measures were self-reported data from three-day dietary recall. Nutrients content and energy value of diet were compared with guidelines for chronic kidney disease patients or, in case of nutrients when they are not settled, with the recommendations for healthy women. RESULTS: All patients had a lower energy intake than the recommended level. At the same time, 35.8% of patients were characterised by improper protein intake--too low or too high. The majority of patients had low intake of most of vitamins and minerals. The total, animal and plant protein were positively correlated with the energy value of diet and with amount of most of the nutrients. Values of GFR were positively correlated with animal protein intake, while phosphate and creatinine in blood were negatively correlated with total and animal protein intake. CONCLUSIONS: The study highlights that diet of CKD predialysis patients with no previous dietary intervention is not properly balanced.

[Analysis of the food rations of predialysis patients with chronic renal failure receiving essential amino acid ketoanalogues]. / Analiza racji pokarmowych osób z przewlekla niewydolnoscia nerek leczonych zachowawczo z zastosowaniem ketoanalogów aminokwasów egzogennych.

The aim of the study was to analyse daily food rations of patients with chronic renal failure (CRF) receiving a supplement containing essential amino acid ketoanalogues (EAAK). The study was carried out on 60 patients with CRF of different etiology. During the progression of CRF, decline of consumption of products being the source of protein and limitation of consumption of products high in energy were observed. This can lead to protein-energy malnutrition. The results of the research emphasize the necessity of providing patients with CRF constant dietician care that would assure possibility to adjust diet to individual needs of every patient as well as to modify it, if necessary, and that would have significant influence on prolongation of the phase of predialysis treatment as well as on better preparation to dialysis.

Analysis of the intake of protein and energy by predialysis patients with chronic renal failure receiving essential amino acid ketoanologues.

The aim of the study was to evaluate daily dietary intake of energy and protein by predialysis patients with chronic renal failure (CRF) receiving a supplement containing essential amino acid ketoanalogues. The study was carried out on 60 patients with CRF of different etiology. Low intake of energy (88% of tested patients) and animal protein (23% of tested patients) were observed, whereas total protein level was too high (33% of tested patients). As a consequence, the analyzed diets were not properly balanced. Our data strongly suggest that constant dietician care is essential to correct protein and energy intake in patients with CRF and can protect them against malnutrition and progression of CFR.

Cross-linked C-terminal telopeptide of type I collagen in serum before and after treatment with alfacalcidol and calcium carbonate in early and moderate chronic renal failure.

The diagnosis of renal osteodystrophy (RO) in chronic renal failure (CRF) in everyday practice depends on noninvasive methods. Still there is no widely accepted bone resorption marker in RO. The aim of the study was to evaluate the correlation of serum cross-linked C-terminal telopeptide of type I collagen (s-CTx) as the resorption marker with clinical and biochemical data and to evaluate s-CTx level changes after treatment with low dose of alfacalcidol and calcium carbonate. Sixty patients (36 men and 24 women) with creatinine serum level 3.0 +/- 1.5 mg% were examined. The result of s-CTx was normal in 27 patients and increased in 33. There was a significant positive correlation of s-CTx and serum creatinine (p < 0.001), alkaline phosphatase activity (p < 0.05) and duration of CRF (p < 0.05) in men and serum creatinine (p < 0.001) and phosphorus (p < 0.05) in postmenopausal women. Patients with increased s-CTx had significantly higher serum creatinine (p < 0.001), phosphorus (p < 0.01), alkaline phosphatase activity (p < 0.001) and longer duration of CRF (p < 0.001) than patients with normal s-CTx. Next, 25 patients were treated for 6 months with alfacalcidol in dose of 0.25 microg every other day and calcium carbonate in dose of 3.0 microg per day and 25 patients with calcium carbonate only. There was a statistically significant decrease of s-CTx in both groups of patients (p < 0.01). We conclude, that in patients with CRF, s-CTx can be taken as the marker of bone resorption changes after treatment of RO but the value of s-CTx as a diagnostic marker in these patients ought to be evaluated in comparison with histomorphometry.