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Patients with chronic kidney disease (CKD) often face difficulties that limit their adherence to a healthy diet, which are related to complications of the disease or factors associated with their environment.
Cross-sectional study with mixed methodology. Forty patients were included: predialysis (n=10), peritoneal dialysis (n=10), hemodialysis (n=10), transplant (n=10), matched by sex. All of them underwent a clinical and nutritional evaluation [anthropometry, body composition (BCM) and dietary quality (Mini-ECCA)]. Barriers and facilitators were evaluated with a qualitative approach, through a semi-structured interview with intensity sampling. Interviews were transcribed and coded to perform a thematic content analysis.
Of the total sample, mean age was 46±17 years, 65% lived in couple, 42% had a paid job and 37% had less than primary school education. In addition, 31% had a healthy diet, 31% in need of improvement and 37% unhealthy. In the qualitative analysis, four categories with 18 barriers codes and three categories with 10 facilitators codes of healthy diet were identified. Main barrier and facilitator categories, by importance, and according to the stage of CKD, are shown in the Table.
In general, main barriers for a healthy diet were dietary restrictions, disgust/aversion for healthy food, and lack of knowledge or nutritional guidance, whereas main facilitators were willingness to eat healthy, orientation and dietary prescription, as well as alternatives to achieve a healthy diet.