IMPACT OF DIETARY INTERVENTION ON QUALITY OF LIFE OUTCOMES IN STAGE 3, 4, AND NON DIALYSIS 5 CKD PATIENTS

Introduction:

The quality of life may be influenced by amount of protein intake in patients of advanced chronic kidney disease. Here, trend of QoL in stage 3, 4, and non dialysis 5 CKD patients with three different protein intake groups were assessed

Methods:

Study was conducted during Nov 2022 to Nov 2023 at a tertiary care center, enrolling all consecutive Non-dialytic CKD 3 to 5 patients. Their demographics, basic disease, life style, literacy, dietary habits and biochemical details were assessed. All were counseled to a prescribed diet based on their eGFR level. Patients were computer randomized into three groups (NP, LP, VLP+KAEAA) in CKD 3 and two groups (LP, VLP+KAEAA) in CKD 4 & CKD 5. Quality of life was assessed by using KDQOL-SF-36TM v1.3 questionnaires at baseline and after a year through interviews. It included- physical component summary score (PCS) and mental component summary score (MCS). The score range for PCS (0-2100) and MCS (0-1400). PCS and MCS are further subdivided into 8 dimensions (According SF-36 survey): physical functioning, physical role functioning, pain, general health, Emotional well-being, emotional role functioning, social functioning, and Energy/Fatigue. Each scale has outcomes ranging from 0 to 100 (worst to best possible condition). Base line and one year progression of QoL was analyzed

Results:

A total 199 CKD patients of stage 3(89), Stage 4(63), Stage 5(47) were analyzed. Study population showed male 120(63.15%), mean age 45 years and sedentary lifestyle 167 (87.89%) respectively. There were non-significant decrease in PCS and MCS over one year across all the three diets and CKD groups (Table-1). As a PCS component, physical functioning declined across all diet groups; particularly with LP and VLP+KAEAA (p= 0.00 and p= 0.02) and emotional well being non-significantly improved with LP and VLP + KAEAA in CKD Stage 3. In CKD Stage 5, the VLP + KAEAA led to significant improvements in Pain (p=0.00) and burden of kidney disease (p= 0.05). However there were no significant changes of specific components of PCS and MCS in CKD stage 4 (Fig-1).

Figure: 1 Percentage of increase or decrease in QoL parameters for CKD stages. A. CKD 3, B. CKD 4, and C. CKD 5.

Conclusions:

Appropriate dietary intervention does not deteriorate quality of life significantly among all types of diet and CKD groups. Further, there were improving emotional well-being, pain and kidney disease burden feeling especially in latter stage of CKD.

I have potential conflict of interest to disclose.
Funded by ICMR & Supported by AUBADE HEALTHCARE PVT LTD DELHI

I did not use generative AI and AI-assisted technologies in the writing process.