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Randomized controlled trial of nutritional counseling on body composition and dietary intake in severe CKD

Campbell, Katrina L., Ash, Susan, Davies, Peter S.W. , & Bauer, Judith D. (2008) Randomized controlled trial of nutritional counseling on body composition and dietary intake in severe CKD. American Journal of Kidney Diseases, 51(5), pp. 748-758.

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Abstract

Background: Progressive loss of kidney function results in an increased risk of malnutrition. Despite this, there is little evidence informing the impact of nutrition intervention on predialysis patients with chronic kidney disease (CKD; stages 4 and 5).

Study Design: Randomized controlled trial.

Setting & Participants: 56 outpatients (men, 62%; mean age, 70.7 ± 14.0 [SD] years) with CKD were randomly allocated to intervention (n = 29) or control (n = 27) by using a concealed computer-generated sequence.

Intervention: The intervention group, provided with individualized dietary counseling with regular follow-up aimed at achieving an intake of 0.8 to 1.0 g/kg of protein and greater than 125 kJ/kg of energy, or control, receiving written material only.

Outcomes & Measures: Change in body composition (body cell mass, measured by means of total-body potassium, in 40 of 56 participants), nutritional status (Subjective Global Assessment), and energy and protein intake (3-day food record).

Results: During the 12 weeks, the intervention group had 3.5% (95% confidence interval, −2.1 to 9.1) less decrease in body cell mass, 17.7-kJ/kg/d (95% confidence interval, 8.2 to 27.2) greater increase in energy intake, greater improvement in Subjective Global Assessment (P < 0.01), and no significant difference in protein intake compared with the control group (−0.04 g/kg/d; 95% confidence interval, −0.73 to 0.16). The intervention was associated with greater increases in energy and protein intake in women than men (interaction P < 0.001 for both).

Limitations: Power to detect change in body cell mass, potential bias in ascertainment of Subjective Global Assessment.

Conclusions: In predialysis patients with CKD, structured nutrition intervention had a greater effect on energy and protein intake in women than men. Additional investigations are warranted to determine the impact on body composition.

Impact and interest:

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ID Code: 18882
Item Type: Journal Article
Additional URLs:
Keywords: Nutrition Intervention, Chronic Kidney Disease, Predialysis, Randomized Controlled Trial, Body Cell Mass, Dietary Counseling
DOI: 10.1053/j.ajkd.2007.12.015
ISSN: 0272-6386
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Nephrology and Urology (110312)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100) > Nutritional Physiology (111103)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100) > Nutrition and Dietetics not elsewhere classified (111199)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Copyright Owner: Copyright © 2008 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Copyright Statement: This is the author’s version of a work that was accepted for publication in <American Journal of Kidney Diseases>. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in American Journal of Kidney Diseases, [VOL 51, ISSUE 5, (2008)] DOI: 10.1053/j.ajkd.2007.12.015
Deposited On: 31 Mar 2009 15:07
Last Modified: 01 Mar 2012 14:14

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