A Randomized Controlled Trial of Dietary and Lifestyle Modification based on the Empowerment Approach among Chronic Kidney Disease Patients
ยุพา ชาญวิกรัย*, Buncha Satirapod
Dollapas Punpanich, Ouppatham supasyndh, Division of nephrology, Phramongkutklao Hospital, Bangkok, Thailand
บทคัดย่อ
Changes of diet and lifestyle can slow the progression of chronic kidney disease (CKD). We aimed to study the effect of dietary modification with or without exercise by the empowerment approach in CKD patients. The 12-week protocol was conducted in patients with CKD stage 3-5. The participants were randomly assigned to be a standard care (C) group, a diet-managed (D) group or a diet plus exercise-managed (DE) group. All groups were advised on low protein (0.6-0.8http://www.krcp-ksn.com/webfiles/images/transparent.gifg/kg/day) and low salt (5http://www.krcp-ksn.com/webfiles/images/transparent.gifg/day) diet. Group D and DE participated in the empowerment activities during the study. Blood and urine were collected for nutrition evaluation. Eighty-one patients completed the study program (96%). At baseline, there was not significantly difference in characteristics among the three groups, whereas, at the end of the study, there were significantly decreased in systolic (SBP) and diastolic BP (DBP), and normalize protein nitrogen appearance (nPNA) in group D and DE, when compared with C. (Table)
 
Mean ± SD at the end of study
p
 
C (n = 27)
D (n = 28)
DE (n = 26)
 
SBP, mmHg
138.94±19.41
132.21±19.04
125.19±12.5
0.019*
DBP, mmHg
75.14±9.06
66.5±8.55
70.31±11.94
0.010*
BUN, mg/dL
26.6±0.28
28.5±14.34
25.7±16.04
0.791
SCr, mg/dL
1.95±0.21
2.07±0.85
2.07±1.08
0.986
Salb, g/dL
4.15±0.21
4.31±0.44
4.4±0.32
0.541
nPNA,g/kg/d
0.94±0.33
0.74±0.28
0.75±0.19
0.020*
UrineNa, mg/d
3298.41±1578.6
2489.47±1364.05
2873.39±1008.19
0.09
http://www.krcp-ksn.com/webfiles/images/FLA/Glyphs/u204e.gifp<0.05 vs. group C, Scr: serum creatinine, Salb: serum albumin, UrinNa: urine sodium
We summarized that dietary and lifestyle modification based on the empowerment approach improved SBP, DBP and reduced dietary protein intake, and it might help CKD patients reduce salt intake.
ที่มา
Kidney Research and Clinical Practice ปี 2555, June ปีที่: 31 ฉบับที่ 2 หน้า A95