Evaluation of the effectiveness of specialized diet therapy in patients with chronic renal failure receiving treatment with programmed hemodialysis

The objective: to develop and evaluate the effectiveness of the use of specialized dietary diets in patients with chronic renal failure (CRF) receiving treatment with program hemodialysis (PGD) based on a comprehensive assessment of nutritional status using modern methods of nutimetabolomic.

Patients and methods. This study included 60 patients with chronic renal failure who received PGD treatment (mean age 58.6 [55.5, 61.6] years). The average duration of hemodialysis was 8.0 [8.0, 11.2] years. In this group, 3 (5%) patients had a body mass deficit (BMI less than 18.5 kg/m2), 20 (33.3%) – normal body weight (BMI 18.5–24.9 kg/m2), 22 (36.7%) – overweight (BMI 25–29.9 kg/m2), 15 (25%) – obesity (BMI more than 30.0 kg/m2). Of the concomitant diseases in patients in this group, iron deficiency anemia was diagnosed in 58 (96.7%), arterial hypertension in 33 (55%), ischemic heart disease (IHD) in 11 (18.3%), secondary Hhyperparathyroidism in 23 (38.3%), peptic ulcer of the stomach and duodenum in 8 (13.3%), cholelithiasis in 7 (11.6%), hepatitis C in 6 (10%), hepatitis B in 3 (5%). An analysis of the nutritional status of patients with CRF receiving PGD treatment was carried out. 

Results. Application in diet therapy for patients receiving treatment PGD specialized dietary ration, the modified energy value (35 Kcal/kg/day), protein content (1.2 g/kg/day), fat (30–40% of daily caloric intake), carbohydrates (55–60% of total calories) and macrocells (phosphorus 800 – 1000 mg/day; potassium 2000–3000 mg/day; sodium – no more than 2000 mg/day calcium – less than 2000 mg/day) is associated with positive dynamics of the body composition indicators (decrease in total mass of liquid while maintaining a stable fat mass and skeletal mass) decrease in serum creatinine, urea, uric acid, potassium, and phosphorus, as well as a significant increase in total protein and albumin levels.

Conclusion. The effectiveness of specialized diet therapy in correction of metabolic disorders and reduce the risk of complications in patients with chronic renal failure treated with PGD is shown.

Key words: specialized nutritional therapy, nutritional status, chronic renal failure, hemodialysis program.

For citation: Zuglova E.A., Kaganov B.S. Evaluation of the effectiveness of specialized diet therapy in patients with chronic renal failure receiving treatment with programmed hemodialysis. Vopr. dietol. (Nutrition). 2017; 7(2): 5–9. (In Russian).
DOI: 10.20953/2224-5448-2017-2-5-9