EFFECTIVENESS OF COMPREHENSIVE LIFESTYLE AND NUTRITIONAL COUNSELING FOR OUTPATIENTS WITH CHRONIC KIDNEY DISEASE

 

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https://storage.unitedwebnetwork.com/files/1099/f709c32a893adb0c6882eaea2b17f064.pdf
EFFECTIVENESS OF COMPREHENSIVE LIFESTYLE AND NUTRITIONAL COUNSELING FOR OUTPATIENTS WITH CHRONIC KIDNEY DISEASE

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Ryoko
Tatsumi
Ryoko Tatsumi rytatsumi@gmail.com Osaka Keisatsu Hospital Nephrology Osaka Japan *
Kohei Oka oka.kohei89@oim.or.jp Osaka Keisatsu Hospital Nephrology Osaka Japan -
Haruna Tanoue tanoue.haruna77@oim.or.jp Osaka Keisatsu Hospital Nephrology Osaka Japan -
Rina Oda oda.rina20@oim.or.jp Osaka Keisatsu Hospital Nephrology Osaka Japan -
Kumie Teramoto teramoto.kumie10@oim.or.jp Osaka Keisatsu Hospital Nephrology Osaka Japan -
Takayuki Kawaoka kawaoka.takayuki00@oim.or.jp Osaka Keisatsu Hospital Nephrology Osaka Japan -
Hitoshi Mizuno mizuno.hitoshi07@oim.or.jp Osaka Keisatsu Hospital Nephrology Osaka Japan -
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At our institution, comprehensive lifestyle and nutritional counseling is provided to outpatients with chronic kidney disease (CKD), including physician consultations, nursing guidance by registered nurses, and nutritional counseling by dietitians. This study aimed to evaluate the impact of such multidisciplinary interventions on renal function and patient behavior.

We retrospectively analyzed 51 outpatients who initiated comprehensive counseling between November 2022 and December 2024 and continued follow-up for at least six months. Renal function trajectory was assessed using the Long-Term eGFR Plot (LTEP), comparing the annual change in estimated glomerular filtration rate (ΔeGFR) before and after the intervention. Urinary protein levels and the rate of home blood pressure monitoring were also evaluated.

The mean age at initiation was 69.9 ± 11.1 years, and the median baseline eGFR was 22.4 [17.8–34] mL/min/1.73m². Of the 51 patients, 39 (76.5%) had CKD stage G4 or G5. The median observation period was 35 [13.5–78] months before and 16 [10–26] months after the intervention. Improvement in ΔeGFR was observed in 31 patients (60.8%). Median ΔeGFR before guidance was -3.7 [-9.45 to -1.4] mL/min/1.73m²/year, compared to -2.2 [-4.7 to 0.1] mL/min/1.73m²/year after guidance (p = 0.024). Urinary protein levels tended to decrease, but the difference was not significant. The proportion of patients performing home blood pressure monitoring significantly increased from 70.6% to 94.1% (p = 0.003).

Comprehensive lifestyle and nutritional counseling was associated with a significant deceleration in CKD progression. The increased rate of home blood pressure monitoring suggests that the intervention may have promoted behavioral change. These findings indicate that comprehensive counseling may contribute to slowing renal function decline by facilitating patient engagement in self-management.

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