title: Diet and polycystic kidney disease: A pilot intervention study.
abstract: Dietary sodium, protein, acid precursors, and water have been linked to cyst growth in polycystic kidney disease; yet, no studies in patients have examined the feasibility of using a dietary intervention that controls all of these factors. The aim of this study was to determine if a diet, appropriate for persons of most ages, reduces the excretion of sodium, urea, acid, and decreases mean urine osmolality while gaining acceptance by patients with autosomal dominant polycystic kidney disease (ADPKD).
  
  
  
  Twelve adults with ADPKD enrolled in a pre-post pilot feasibility study and served as their own controls. Individuals consumed their usual diet for one week then for four weeks followed an isocaloric diet lower in sodium and protein and higher in fruits, vegetables, and water. Three-day diet records and two 24-h urine samples were collected at baseline, week 2, and week 4 visits; blood pressure, weight, and serum were obtained at all three visits. A modified nutrition hassles questionnaire was completed on the last visit.
  
  
  
  During the dietary intervention, subjects (n = 11) consumed less sodium, protein, and dietary acid precursors 36%, 28%, and 99%, respectively, and increased fluid intake by 42%. Urinary sodium, urea, net acid excretion, osmoles, and osmolality decreased 20%, 28%, 20%, 37%, and 15%, respectively; volume increased 35%. Urine changes were in accord with the diet record. Ninety-one percent of participants reported that none of the hassles were worse than "somewhat severe", and most participants felt "somewhat confident" or "very confident" that they could manage the new diet.
  
  
  
  A majority of adult patients with ADPKD successfully prepared and followed a composite diet prescription with decreased sodium, protein, acid precursors, and increased fluid intake. This trail was registered at ClinicalTrials.gov (NCT01810614).
authors.affiliation: Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Department of Nutrition Services, Children's Mercy Hospital & Clinics, Kansas City, MO, USA. Electronic address: j.m.taylor@umcg.nl.
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Taylor
authors.affiliation: Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: jhamilton-reeves@kumc.edu.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Hamilton-Reeves
authors.affiliation: Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: dsulliva@kumc.edu.
authors.forename: Debra K
authors.initials: DK
authors.lastname: Sullivan
authors.affiliation: Department of Internal Medicine, Division of General Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: cgibson@kumc.edu.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Gibson
authors.affiliation: Department of Medicine-Nephrology, Kidney Institute, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: ccreed@kumc.edu.
authors.forename: Catherine
authors.initials: C
authors.lastname: Creed
authors.affiliation: Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: scarlson@kumc.edu.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Carlson
authors.affiliation: Department of Internal Medicine, Baylor Scott and White Health, Texas A&M Health Science Center College of Medicine-Temple Campus, USA. Electronic address: dwesson@sw.org.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Wesson
authors.affiliation: Department of Medicine-Nephrology, Kidney Institute, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: jgrantha@kumc.edu.
authors.forename: Jared J
authors.initials: JJ
authors.lastname: Grantham
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet; D015930:Diet Records; D004044:Dietary Proteins / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010865:Pilot Projects; D016891:Polycystic Kidney, Autosomal Dominant / Q000178:diet therapy*; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage / Q000652:urine; D011795:Surveys and Questionnaires; D014508:Urea / Q000652:urine; D014675:Vegetables
chemical_list: D004044:Dietary Proteins; D017673:Sodium Chloride, Dietary; D014508:Urea
keywords: Dietary acid load; Net acid excretion; Net endogenous acid production; Polycystic kidney disease; Potential renal acid load; Renal nutrition
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