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The effect of low-protein diet on progression of chronic kidney disease
Čmerdová, Kristýna ; Karbanová, Miroslava (advisor) ; Tesař, Vladimír (referee)
Background: Low protein diet is one of the treatments for patients with chronic kidney disease during the pre-dialysis period. Studies about this subject have been published for more than 20 years, but the conclusions about its effect and the most appropriate composition are not clear. A low-protein diet is recommended for some patients at the Nephrology Clinic of General University Hospital. These patients are educated and re- educated by a nutrition therapist who also controls their food intake through a food diary. Objectives: To evaluate the effect of low-protein diet on the progression of chronic kidney disease in our conditions and to compare the results with the control group. Furthermore, to evaluate the nutritional status of these patients and the influence of the diet on it. Last but not least, describe a set of patients coming to education about low-protein diet. Methods: The input data was retrospectively retrieved from the medical records of patients who attended medical checks at the Nephrology Clinic of General University Hospital between 10/2016 and 3/2018. A group of 15 patients with a low-protein diet was compared with a control group of 15 patients who did not receive low-protein diet education. The main data collected was year of birth, estimated GFR, urea, creatinine, albumin,...
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The effect of low-protein diet on progression of chronic kidney disease
Čmerdová, Kristýna ; Karbanová, Miroslava (advisor) ; Tesař, Vladimír (referee)
Background: Low protein diet is one of the treatments for patients with chronic kidney disease during the pre-dialysis period. Studies about this subject have been published for more than 20 years, but the conclusions about its effect and the most appropriate composition are not clear. A low-protein diet is recommended for some patients at the Nephrology Clinic of General University Hospital. These patients are educated and re- educated by a nutrition therapist who also controls their food intake through a food diary. Objectives: To evaluate the effect of low-protein diet on the progression of chronic kidney disease in our conditions and to compare the results with the control group. Furthermore, to evaluate the nutritional status of these patients and the influence of the diet on it. Last but not least, describe a set of patients coming to education about low-protein diet. Methods: The input data was retrospectively retrieved from the medical records of patients who attended medical checks at the Nephrology Clinic of General University Hospital between 10/2016 and 3/2018. A group of 15 patients with a low-protein diet was compared with a control group of 15 patients who did not receive low-protein diet education. The main data collected was year of birth, estimated GFR, urea, creatinine, albumin,...
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Nutrition of dialysis patient
ŠIKOLOVÁ, Nela
My Bachelor's thesis ,,Nutrition of dialyzed patient" is divided into two parts, the theoretical and practical one. The theoretical one consists of eight chapters. The first chapter deals with kidney anatomy. I briefly describe the shape, size, position and vascular supply to kidneys. I also mention the basic functional unit - nephron, as well as primary and final urine creation which is connected with it. The second chapter is focused on three main kidney functions. The first one is excretory which means elimination of waste and extraneous substances. The second function is metabolic when kidneys participate in managing ions and water in the body and thus they keep homeostasis of internal environment. The third function is endocrine; in the course of this function, kidneys secrete renin, kallikrein, prostaglandins, and erythropoetin and they participate in vitamin D metabolism and degradation of insulin. In the third chapter I characterize kidney diseases and I try to reveal the main causes of their formation. I specifically deal with primary and secondary glomerulopathy, acute, sub-acute and chronic glomerulonephritis. The conclusion of this chapter is devoted to acute and chronic tubulointerstitial nephritis; moreover I mention the most frequent hereditary kidney diseases. In the fourth chapter, I describe renal insufficiency and renal failure which is divided into acute and chronic. Acute renal failure is divided according to its main cause into pre-renal (functional), renal (impairment of renal parenchyma) and post-renal (urological). Chronic renal failure is divided according to KDOQI classification into five stages. The fifth chapter is devoted to metabolic effects (consequences) of renal diseases when the impairment of excretory, metabolic and endocrine renal function occurs (endocrine renal function influences all our body). I aim at acid-base disturbances, water and electrolyte metabolism, calcium-phosphate metabolism, hormonal function, metabolism of proteins, fats, carbohydrates, vitamins and trace elements. In the sixth chapter, I illustrate the diversity of hemodialysis, hemofiltration, hemodiafiltration and peritoneal dialysis. In the seventh chapter, I mention a kidney transplant, which is possible from a living donor or cadaver program. The eight chapter is the core of my Bachelor?s work. I deal with dietary and lifestyle changes in patients before a dialysis therapy, during dialysis therapy, and after a kidney transplant. For the practical part, I have chosen some methods of quantitative research. The purpose of the research part was to investigate awareness of dietary regime and how the respondents (patients in chronic dialysis programme in the Hospital in České Budějovice, a.s.) comply with it. I have stated the research question as follows ,,How do dialysed patients comply with dietary regime?". I have applied a method of data gathering which was carried out by means of an anonymous questionnaire. The questionnaire consists of 28 questions, out of which 12 questions are close and 16 are open. The starting point for the evaluation of results of following dialysis regime was questions number 6 to 27. Out of 22 questions, the respondent who follows the diet should have replied 12 and more questions correctly. The results based on a sample population have shown that 25 respondents on dialysis do not follow the dietary regime, while only 15 respondents do follow it. If the dialysis diet is not kept, not only the prognosis of treatment is negatively affected, but first of all medical condition of the patient is being aggravated. To address this problem, I recommend a consultation with a nutrition therapist who would thoroughly educate the patient, especially in terms of main principles in dialysis treatment. The therapist would also compile a diet individually for each patient based on their actual medical condition.
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