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Randomized controlled trial of nutritional counseling on body composition and dietary intake in severe CKD.
Am J Kidney Dis. 2008 May; 51(5):748-58.AJ

Abstract

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).

STUDY DESIGN

Randomized controlled trial.

SETTING & PARTICIPANTS

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.

INTERVENTION

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.

OUTCOMES & MEASURES

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).

LIMITATIONS

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.

Authors+Show Affiliations

Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. katrina.campbell@kcl.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18436085

Citation

Campbell, Katrina L., et al. "Randomized Controlled Trial of Nutritional Counseling On Body Composition and Dietary Intake in Severe CKD." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 51, no. 5, 2008, pp. 748-58.
Campbell KL, Ash S, Davies PS, et al. Randomized controlled trial of nutritional counseling on body composition and dietary intake in severe CKD. Am J Kidney Dis. 2008;51(5):748-58.
Campbell, K. L., Ash, S., Davies, P. S., & Bauer, J. D. (2008). Randomized controlled trial of nutritional counseling on body composition and dietary intake in severe CKD. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 51(5), 748-58. https://doi.org/10.1053/j.ajkd.2007.12.015
Campbell KL, et al. Randomized Controlled Trial of Nutritional Counseling On Body Composition and Dietary Intake in Severe CKD. Am J Kidney Dis. 2008;51(5):748-58. PubMed PMID: 18436085.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized controlled trial of nutritional counseling on body composition and dietary intake in severe CKD. AU - Campbell,Katrina L, AU - Ash,Susan, AU - Davies,Peter S W, AU - Bauer,Judith D, Y1 - 2008/03/03/ PY - 2007/06/19/received PY - 2007/12/26/accepted PY - 2008/4/26/pubmed PY - 2008/5/16/medline PY - 2008/4/26/entrez SP - 748 EP - 58 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 51 IS - 5 N2 - 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). STUDY DESIGN: Randomized controlled trial. SETTING & PARTICIPANTS: 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. INTERVENTION: 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. OUTCOMES & MEASURES: 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). LIMITATIONS: 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. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/18436085/Randomized_controlled_trial_of_nutritional_counseling_on_body_composition_and_dietary_intake_in_severe_CKD_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(08)00003-6 DB - PRIME DP - Unbound Medicine ER -