Taipei Tzu Chi Hospital, Taiwan
Fang-Ching Hu was born in Taipei, Taiwan in 1985. She received her BS degree in Nutrition from Chung Shan Medical University in 2007 and MS degree in Institute of Food Science and Technology from National Taiwan University in 2009. She was qualified as a Registered Dietitian in Taiwan in 2007. She is now a clinical dietitian of Taipei Tzu Chi General Hospital in Taiwan. She is also renal nutrition specialist in Taipei Tzu Chi General Hospital. As a renal dietitian, her major works include individual nutritional counseling, nutritional plans, and group education. She is also a Certified Diabetes Educator in Taiwan. She provides counseling for type 1, type 2 and gestational diabetes patients.
Objectives: Various nutritional interventions for chronic kidney disease (CKD) patients such as protein restriction only, protein restriction with CKD-specific low protein supplements, and protein restriction with keto-analogue or amino acid supplementation have been widely used today. However, protein-energy wasting (PEM) is still a common question in CKD patients. Studies have shown that patients on low protein diets often have difficulty to meet nutritional requirements. This study investigated Taipei Tzu Chi Hospital CKD outpatients’ compliance with CKD-specific low protein supplement and determined the factors which associated with the compliance. Methods: The medical records of CKD outpatients were reviewed retrospectively. Among 1053 CKD patients, 477 were recommended on CKD-specific low protein supplement daily. A telephone interview was performed with the 477 patients to check for the compliance of CKD-specific low protein supplement use. Noncompliers’ reasons for not using CKD-specific low protein supplement were also assessed and analyzed. Results: Among the 477 patients, 352 of them were compliers. The 125 noncompliers included 62 women and 63 men. From the telephone interview, reasons for not using CKD-specific low protein supplements were classified into two major categories: 64.8% were unclear with the concepts of CKD-specific low protein supplements and 20.8% were affected by their families or lived alone. Other reasons for poor compliance were also associated with dissatisfaction with texture and taste (4.8%) and inconvenience of preparing meals (3.2%). Implications & Conclusions: Among Taipei Tzu Chi Hospital CKD outpatients, compliance with CKD-specific low protein supplements was 73%. Most noncompliers had unclear concepts or family issues that prevented them from using supplements. Thus, dietitians should provide CKD-specific low protein supplement education services to CKD patients along with their families to clarify patients’ concepts and seek for better family support.
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