Abstract
Appropriate dietary adjustment in patients with chronic kidney disease (CKD) is important, and nutritional guidelines recommend different dietary management depending on the CKD stage. However, there is no study, to our knowledge, of the characteristics of dietary intake according to CKD stages. We tried to assess the comparison of nutritional intake according to CKD stages. A cross-sectional study was conducted to reveal the characteristics of dietary intake among patients with CKD based on the Korean National Health and Nutritional Examination Survey between 2011 and 2014. Of 16,878 participants, we classified non-CKD (n = 14,952) and CKD (n = 1,926), which was stratified into five groups (I, II, IIIa, IIIb, and IV–V). We investigated the characteristics of dietary intake, such as energy, water, protein, fat, carbohydrate, sodium, potassium, calcium, and phosphorus, according to stage of CKD. We also explored nutritional intake according to CKD stage among patients with early CKD (stage I and II) and advanced CKD (stage IIIa, IIIb, and IV–V). Intake of majority of nutrients and energy tended to be decreased as CKD progressed. In early CKD stage, intake of energy, water, protein, fat, carbohydrate, potassium, calcium and phosphorus seemed to be statistically significant decreased as CKD progressed. In advanced CKD stage, intake of potassium and calcium seemed to be decreased as CKD progressed, but the intake of energy was about to be lower limit. Appropriate dietary education and CKD recognition are needed to improve nutritional intake depending on the CKD stage.
Highlights
The prevalence of chronic kidney disease (CKD) is estimated to be 8–16% worldwide [1], and over 2 million people have end-stage renal disease (ESRD) [2], which is a life-threatening outcome of CKD that requires renal replacement therapy for survival
When subjects were stratified into five groups according to CKD stage and non-CKD, we found significant differences between groups in mean age, the proportion of males, body mass index (BMI), the incidence of hypertension and diabetes mellitus (DM), income, CKD awareness, occupation, residential district, and laboratory findings, while there was no significant difference in the incidence of nutritional education (Table 1)
We assumed that a difference in dietary intake exists between early-stage and advanced-stage CKD, so we explored nutritional intake after stratifying the population into two groups
Summary
The prevalence of chronic kidney disease (CKD) is estimated to be 8–16% worldwide [1], and over 2 million people have end-stage renal disease (ESRD) [2], which is a life-threatening outcome of CKD that requires renal replacement therapy for survival. In the Republic of Korea, the prevalence of CKD in individuals aged >20 years was 8.2% [3]. CKD is one of the most important chronic illnesses that imposes a substantial disease in an aging society [4]. CKD treatment mainly aims to preserve renal function, as renal function continues to decrease with age and renal disease progression or complications. Other than established modifiable risk factors for CKD such as hypertension, diabetes mellitus (DM), and dyslipidemia, recent studies and guidelines suggest that nutrition is an important factor in CKD progression [2]. Nutrition and dietary patterns are often neglected as a therapeutic tools for preventing and slowing CKD progression [8]
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