Title : Impact of personalized nutritional intervention on biochemical and anthropometric parameters in patients with non-dialysis chronic kidney disease (Stages 3-5)
Abstract:
Background: Nutritional therapy is a vital, non-pharmacological strategy for managing Chronic Kidney Disease (CKD), especially in stages 3 through 5, to delay the progression to End-Stage Renal Disease (ESRD). Despite its importance, strict dietary restrictions frequently lead to serious complications such as Protein-Energy Wasting (PEW) or dangerous electrolyte imbalances, including hyperkalemia, due to poor real-world adherence. This research specifically investigates the effectiveness of tailored renal dietetics in a high-burden clinical population, focusing on its ability to stabilize metabolic waste products and correct hyperkalemia.
Objective: To quantify the impact of a 3-month personalized nutritional intervention on dietary intake and biochemical parameters in non-dialysis CKD patients.
Material and Methods: This prospective observational study at King George's Medical University, Lucknow, enrolled 109 patients diagnosed with CKD stages 3-5. The intervention consisted of a personalized nutritional plan with monthly counseling utilizing Subjective Global Assessment (SGA) and motivational interviewing. Baseline and three-month follow-up measurements included 24-hour dietary recall, anthropometry (MUAC, triceps skinfold), and biochemical markers (Hb, urea, creatinine, K+). Data were analyzed using paired sample t-tests.
Results: The intervention significantly improved dietary adherence and clinical markers meeting recommended targets. Energy intake increased from 1444.9±288.7 kcal to 1755.4±282.4 kcal (p<0.001). Hemoglobin rose from 10.1±1.7 g/dl to 11.0±1.3 g/dl (p=0.001), while serum urea (95.8±39.6 mg/dl to 84.0±36.1 mg/dl; p=0.022) and creatinine (3.8±1.2 mg/dl to 2.7±1.0 mg/dl; p=0.001) decreased. Serum potassium also reduced significantly (6.1±1.6 mmol/l to 4.7±0.6 mmol/l; p<0.001). Anthropometric monitoring showed an increase in triceps skinfold (15.5 ± 3.8 to 17.1±3.5 mm; p=0.01), indicating improved energy reserves without muscle wasting.
