Browsing by Author "du Plooy, Talita"

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    The effects of adapted renal dietary guidelines on adherence in hemodialysis patients
    (Stellenbosch : Stellenbosch University, 2021-03) du Plooy, Talita; Ebrahim, Zarina; Esau, Nazeema; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.
    ENGLISH SUMMARY: Background: Renal dysfunction and chronic kidney disease (CKD) is known to affect as much as 10% of the population worldwide.1 The annual mortality rate of hemodialysis patients is as high as 20%, with poor nutritional status being one of the biggest influencers of poor outcomes.2 There is currently an increased awareness of the importance of optimal nutrition and early intervention to address malnutrition.3 Despite the known advantages of nutritional intervention for dialysis patients, the CKD diet remains one of the most complex therapies to teach, understand and moreover, adhere to. Better adherence may be achieved by adapting and simplifying the dialysis patient’s dietary prescription.4 This study assessed whether simplifying the current renal dietary guidelines would have a positive effect in terms of patient adherence to the dietary guidelines and improve nutritional status. Methods: A Quasi-experimental study including 75 hemodialysis patients from 4 dialysis units in Pretoria, South Africa. Adult hemodialysis patients undergoing dialysis 3 times per week between the ages of 18–70 years were included. Each participant’s nutritional status was determined using anthropometrical measurements (body mass index (BMI)), waist circumference, triceps skinfold, mid-upper arm circumference (arm muscle area (AMA)) and biochemical parameters. Dietary intake was determined using a food frequency questionnaire (FFQ). Statistical tests were performed to analyse the stated objectives. Results: Seventy-five participants were enrolled^ 42 participants in the intervention group and 33 in the control group. The mean age of the population was 55 years (± 10.90). Fifty-five of the participants (73%) have been on dialysis for longer than 2 years. In terms of gender, 52 (69.33%) of the study population were male and 23 (30.67%) female. The majority of participants were well educated with a high household income. The most prevalent chronic illness reported was hypertension in 66 (88%) of the participants. The average BMI of the population at baseline was 26.6kg/(m²) (± 5.40) with 42 (56%) participants being overweight or obese. The majority of participants, 52 (69.33%), presented with an average AMA. The average protein intake of the group was within the recommendation at 1g/kg/day. The population showed a high intake of saturated fats and refined sugar. The average fiber intake was 20.68g/day (±10.86), which is lower than the recommendation of 25g/day. An improvement in adherence to the renal dietary guidelines was seen in all aspects in both the intervention and the control group. After the intervention, the total adherence for the population improved by 15%, although adherence remained poor in terms of fruit, vegetables and fiber intake. When comparing the improvement in adherence to the renal dietary guidelines between groups, no statistically significant difference was found between the traditional vs simplified guidelines (p = 0.341). Conclusion: Both the control and the intervention group received in-depth dietary education which might explain an equal improvement in terms of adherence. Given the high prevalence of overweight and obesity in end-stage renal disease, the management thereof should form an integral part of the nutritional intervention. Further intervention should focus on weight loss and increasing fruit, vegetable and fiber intake.