Association of socio-psychological factors with the effects of low protein diet for the prevention of the progression of chronic renal failure.
OBJECTIVE
Our objectives were to investigate the therapeutic effects of low protein diet (LPD) for chronic renal failure (CRF) in compliant patients with the diet, and to clarify the relationships to the sociopsychological factors.


METHODS
Sixty-five patients (47 men and 18 women) with CRF who followed LPD (0.69 g/kg/day) for more than 3 months were recruited in this study. Compliance with the diet therapy was strictly assessed by the patients' dietary records, subsequent interviews regarding the status of daily dietary intake and estimated protein intakes calculated from urinary nitrogen excretion by 24-hour urine collections. The changes of glomerular filtration rate (GFR), serum creatinine (Cr), blood urea nitrogen (BUN), the reciprocal of serum creatinine (1/Cr), scores of Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), scales of Profile of Mood States (POMS), scores of self-efficacy and social support were investigated.


RESULTS
Decline rate of GFR, elevation of Cr and BUN and reduction in 1/Cr were significantly lower in compliant patients than in noncompliant patients (p<0.05). There were no differences in SF36 scores between compliant and noncompliant patients. The POMS scales of depression/dejection were high in female noncompliant patients compared to other groups of patients (p<0.05). Self-efficacy score was higher in compliant patients than in noncompliant patients (p<0.05). Social support scores were significantly higher in male compliant patients than in others (p<0.05), and both emotional support and behavioral support showed interaction with both gender and compliance with diet therapy (p<0.05).


CONCLUSIONS
LPD therapy is effective in suppressing the progression of CRF when it is well-adhered to. There are no correlations of this diet therapy to health-related QOL. Social support and high self-efficacy for men and high self-efficacy for women are associated with improvement of the compliance with LPD therapy, leading to good therapeutic effects.
Department of Preventive Medicine & Public Health, Tokyo Medical University, Tokyo.
Yoshie
Y
Kanazawa
Toshiyuki
T
Nakao
Yumiko
Y
Ohya
Teruichi
T
Shimomitsu
D000328:Adult; D000339:Affect; D018753:Diet, Protein-Restricted / Q000523:psychology*; D004044:Dietary Proteins / Q000008:administration & dosage; D018450:Disease Progression; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007676:Kidney Failure, Chronic / Q000178:diet therapy* / Q000523:psychology; D008297:Male; D008603:Mental Health; D011788:Quality of Life; D012944:Social Support
D004044:Dietary Proteins