Effects of Intensive Dietary Counseling versus Standard Dietary Counseling in Chronic Kidney Disease Patients: The Pilot Study

Abstract

Background: Chronic kidney disease (CKD) is a major public health problem worldwide, particularly in Thailand. Several studies have recommended limiting protein and sodium intake with the benefit of delaying kidney deterioration. Hence, dietary counseling is recommended for CKD patients. We aimed to explore and compare the effects of intensive dietary counseling (In-counseling) and standard dietary counseling (Sd-counselling) for controlling protein and sodium intake.

Methods: The present study was an open-labeled randomized control trial. The participants were stage III – IV CKD patients who were stable on their current treatment. The Id-counseling group received 30-minute monthly lessons with advice on dietary intake. The Sd-counseling group received the usual standard of care. The outcomes were daily protein intake (DPI) and 24-hour urinary sodium (UNa) at two months.

Results: Twenty CKD patients were divided into two groups of 10 participants each. Baseline characteristics were similar in both groups, except there were more CKD stage 4 patients in Sd-counselling group (3 vs 1 participant). The three most common comorbidities were hypertension (80%), dyslipidemia (70%) and diabetes mellitus (50%). Baseline DPI and 24-hour UNa were similar in both groups. After 2 months, the DPI of the In-counseling group achieved greater target-control than Sd-counseling. There was a trend to decrease 24-hour UNa between before and after counseling in In-counseling group. However, the DPI and 24-hour UNa at the end of the study was not statistically significant.

Conclusion: Although our study did not show significant benefit from In-counselling, it might be due to a small sample size and short time period. There was, however, some trend showing a benefit of In-counselling. A larger scale randomized controlled trial should be conducted to explore this benefit.