Abstract

Objective. The objective of this descriptive study was to assess the practices of South African dietitians regarding the dietary treatment of patients with chronic renal failure. Subjects and design. A questionnaire was mailed to 600 randomly selected dietitians registered with the Health Professions Council of South Africa. Practices were compared to international standards for pre-dialysis, haemodialysis (HD) and peritoneal dialysis (PD) patients. Results. A 26% response rate was obtained, with only 28% of these dietitians indicating that they counsel renal patients. The majority of dietitians met the international dietary recommendations, but a substantial number deviated from them. This was especially evident in PD patients, where the deviation ranged from 20% (4 dietitians) in the case of energy and phosphate, to 55% (11 dietitians) in the case of calcium. Parameters used for the assessment of nutritional status included body mass index (45% of dietitians), serum albumin (44%), clinical examinations (43%), bioelectrical impedance (37%) and diet history (36%). Methods used to monitor dietary compliance included biochemistry, dietary history, anthropometric measurements and clinical investigation. The most frequently used approaches in the management of protein-energy malnutrition included supplemental drinks (86%) and dietary enrichment at household level (76%).

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