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Nutritional Status in Stage V Dialyzed Patient Versus CKD Patient On Conservative Therapy Across Different Economic Status

Abstract

Objective: The objective of this study was to assess the nutritional status in Indian CKD patients and to compare the nutritional indicators between Stage 5 dialyzed(CKD-D) patients below the poverty line (BPL), and Stage 3-4 non-dialyzed(CKD-ND) patients above(APL) and below the poverty line. Design: This cross-sectional study involved 3 centers of CKD patients from Chennai city. Subjects and setting: The subjects were selected from a public Government medical college hospital, a charity based outpatient dialysis unit and a non-profit tertiary care center. The study groups included below poverty line (BPL) CKD-ND (n=100), below poverty line (BPL) CKD-D (n=98) and above poverty line (ABL) CKD-ND (n=92) patients, based on a cut-off of per capita income US $1.25 a day. Methods: Patients were enquired by a qualified renal dietitian about their vegetarian / non-vegetarian pattern of diet, and daily energy and protein intake by 24 hour recall method. Anthropometric measurements and biochemical investigations were made to assess their nutritional status and were compared. Results: Nutritional indicators were found to be low in all 3 groups compared to those prescribed by European Best Practice Guidelines (EBPG). BPL CKD-D patients had low serum albumin levels (32.44444 ± 6.279961g/L; p=0.017) and 41.83% of them were underweight. The APL CKD-ND group registered the lowest mean daily energy (22.576 ± 6.289 kcal/kg/day) and protein intake (0.71 ± 0.06 g/kg/day), due to dietary restrictions imposed on them by themselves and unqualified renal dietitians. The APL group had better indicators of nutritional status than lower income groups in terms of mid upper arm circumference (p=0.001), triceps skin fold thickness (p<0.001) and serum hemoglobin (p<0.001). Conclusion: Several nutritional parameters were below the recommended international guidelines for all the 3 groups, though the high income group had better parameters from several indicators. There is an urgent need for nutritional counseling for CKD-D and CKD-ND patients.

Citation: Vijayan M, Abraham G, Alex ME, Vijayshree N, Reddy Y, et al. (2013) Nutritional Status in Stage V Dialyzed Patient Versus CKD Patient On Conservative Therapy Across Different Economic Status. J Nutr Disorders Ther 3:127. 

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