Dietary satisfaction and quality of life in chronic kidney disease patients on low-protein diets: a multicentre study with long-term outcome data (TOrino-Pisa study).

Abstract

BACKGROUND:

Concerns about adherence and quality of life (QoL) limit the diffusion of low-protein diets (LPDs) as a way to slow chronic kidney disease (CKD) progression and postpone dialysis. The aim of this multicentre study is to assess dietary satisfaction in stable CKD patients.

METHODS:

This was a multicentre cross-sectional study with long-term follow-up data. Prevalent patients on LPD for at least 6 months were selected in four Italian centres. QoL was assessed using the World Health Organization Quality of Life questionnaire, and diet satisfaction with the Modification of Diet in Renal Disease satisfaction questionnaire. Comorbidity was assessed by Charlson Comorbidity Index, estimated glomerular filtration rate (eGFR) was calculated by the CKD Epidemiology Collaboration equation and protein intake by Maroni-Mitch formula. Survival was analysed with Kaplan-Meier curves and Cox Proportional Hazard Model.

RESULTS:

Four hundred and twenty-two CKD Stages 3-5 patients were enrolled. Over 95% were on moderately restricted diets (0.6 g/kg/day). Compliance was good (protein intake: 0.59 g/kg/day at baseline, 0.72 at the end of follow-up). Median dietary satisfaction was 4 on a 1-5 scale. QoL was not affected by the type of diet, but was influenced by age, comorbidity and setting of care. Two years later, at the end of follow-up, 66.6% of the patients were still on a diet; the main causes of discontinuation were dialysis and death. The dropout rate was low (5.5%); in Cox analysis, patient and renal survival were influenced by age and eGFR, but not by QoL, setting of care or type of diet.

CONCLUSIONS:

LPDs are compatible with high dietary satisfaction and minimal dropout, at least in patients who are able to follow such a diet for at least 6 months.

• Authors: Giorgina Barbara Piccoli, Biagio Raffaele Di Iorio, Antoine Chatrenet, Claudia D'Alessandro, Marta Nazha, Irene Capizzi, Federica Neve Vigotti, Antioco Fois, Stefania Maxia, Patrick Saulnier, Gianfranca Cabiddu, Adamasco Cupisti
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 35 Issue 5 Pg. 790-802 (05 01 2020) ISSN: 1460-2385 [Electronic] England
• PMID: 31435654 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Cross-Sectional Studies
• Diet, Protein-Restricted (methods, mortality)
• Disease Progression
• Female
• Glomerular Filtration Rate
• Humans
• Male
• Middle Aged
• Patient Compliance (statistics & numerical data)
• Personal Satisfaction
• Prognosis
• Quality of Life
• Renal Insufficiency, Chronic (diet therapy, metabolism, mortality)
• Survival Rate
• Young Adult