Nutritional status in stage V dialyzed patient versus CKD patient on conservative therapy across different economic status.
BACKGROUND
This aim of this multi-centric cross-sectional study was to assess the nutritional status in Indian chronic kidney disease (CKD) patients and to compare the nutritional indicators between stage 5 dialyzed (CKD-D) patients below the poverty line (BPL), and stage 3-4 non-dialyzed (CKD-ND) patients above (APL) and below the poverty line.


METHODS
Patients were selected from a government medical college hospital, a charity-based outpatient dialysis unit, and a non-profit tertiary care center. The study groups included BPL CKD-ND (n = 100), BPL CKD-D (n = 98), and APL CKD-ND (n = 92) patients, based on a cut-off of per capita income US $1.25 a day. Patients were enquired by a qualified renal dietitian about their pattern of diet, and daily energy and protein intake by 24 h recall method. Anthropometric measurements and biochemical investigations were made and compared.


RESULTS
Nutritional indicators were low in all three groups compared to those prescribed by European Best Practice Guidelines (EBPG). BPL CKD-D patients had low serum albumin levels (32.44444 ± 6.279961 g/L; p = 0.017) and 41.83% of them were underweight. The APL CKD-ND group registered the lowest mean daily energy (22.576 ± 6.289 kcal/kg/day) and protein intake (0.71 ± 0.06 g/kg/day), due to dietary restrictions imposed on them by themselves and unqualified renal dietitians. The APL group had better indicators of nutritional status in terms of mid-upper arm circumference (p = 0.001), triceps skin fold thickness (p < 0.001), and serum hemoglobin (p < 0.001).


CONCLUSIONS
Several nutritional parameters were below the recommended international guidelines for all the three groups, though the high income group had better parameters from several indicators. There is an urgent need for nutritional counseling for CKD-D and CKD-ND patients.
Government Kilpauk Medical College , Chennai, Tamil Nadu , India .
Madhusudan
M
Vijayan
Georgi
G
Abraham
Merina E
ME
Alex
N
N
Vijayshree
Yuvaram
Y
Reddy
Edwin
E
Fernando
Milly
M
Mathew
Sanjeev
S
Nair
Anand
A
Yuvaraj
D000328:Adult; D000368:Aged; D000886:Anthropometry; D003430:Cross-Sectional Studies; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007182:Income; D008297:Male; D044342:Malnutrition / Q000150:complications*; D008875:Middle Aged; D009752:Nutritional Status; D011203:Poverty; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy*; D012709:Serum Albumin / Q000378:metabolism
D004044:Dietary Proteins; D006454:Hemoglobins; D012709:Serum Albumin