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


METHODS
Randomized controlled trial.


METHODS
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.


METHODS
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.


METHODS
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).


CONCLUSIONS
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.
Campbell
Katrina L
KL
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. katrina.campbell@kcl.ac.uk
Ash
Susan
S
Davies
Peter S W
PS
Bauer
Judith D
JD
D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D003376:Counseling; D004032:Diet; D015930:Diet Records; D004035:Diet Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D051436:Renal Insufficiency, Chronic / Q000178:diet therapy* / Q000503:physiopathology