A practical approach to the nutritional management of chronic kidney disease patients in Cape Town, South Africa

Ameh, Oluwatoyin I.; Cilliers, Lynette; Okpechi, Ikechi G.

doi:10.1186/s12882-016-0297-4

Cited by 16 publications

(20 citation statements)

References 18 publications

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“…The African experience shows that a well-balanced diet, with a restricted protein content, can be proposed in many contexts, including low-income, low-literacy settings [15, 16]. Given the “silent epidemic” of illiteracy in developed countries, the strategies developed in Africa can be used in Europe, as an Italian case report explains [17].…”

Section: Low-protein Diets From a Global Perspectivementioning

confidence: 99%

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‘Let food be thy medicine…’: lessons from low-protein diets from around the world

Piccoli

Cupisti

2017

BMC Nephrol

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In this editorial we present the special issue dedicated to low-protein diets (LPDs) in chronic kidney disease, from a global perspective.The experiences gathered from several countries across all continents have created an issue which we hope you will find insightful, and lead to further discussion on this interesting topic.We discover that LPDs are feasible in both developed and low income countries, in patients where literacy is an issue, and are also safe, including during pregnancy and in old age.Patients prescribed a low protein diet are more inclined to follow and adhere to this change in lifestyle, provided the diet has been adapted to meet their own individual needs. With an increasing list of different menu options and better medical advice being offered we no longer need to identify low protein diets with a specific menu, ingredient or supplement, or with a specific level of protein restriction. Evidence shows how the best diet is often the one chosen by the patients, which doesn’t drastically affect their day-to-day life, and delays the start of dialysis for as long as is safe under careful clinical control. The colourful menus gathered from all over the world remind us that a low protein diet does not necessarily mean that the pleasure of preparing a delicious meal is lost. The final comment is therefore dedicated to our patients: low protein diets can be beautiful.

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Section: Low-protein Diets From a Global Perspectivementioning

confidence: 99%

“…In countries such as Australia or the US, in which the normal protein intake is well above 1.2 g of protein per kg of body weight per day, a feasible dietary protein reduction would probably be a protein intake of 0.8 g/kg/day. A similar intake may be needed in poorer countries, for balancing malnutrition [16, 32, 33]. …”

Section: Low-protein Diets Are Feasiblementioning

confidence: 99%

‘Let food be thy medicine…’: lessons from low-protein diets from around the world

Piccoli

Cupisti

2017

BMC Nephrol

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“…Finally, it is important to provide practical advice: no more structured dietary plans, nutritionally sound but complex to realize, or long lists of foods to exclude (potassium, phosphorus, sodium, protein lists), but useful and simplified basic information on how to change habits and help patients combine ingredients to create enjoyable meals that fit recommendations for CKD (47)(48)(49). What treatment for calcium/PTH will affect CKD progression?…”

Section: Consequences Of Unintentional Weight Lossmentioning

confidence: 99%

Retarding Chronic Kidney Disease (CKD) Progression: A Practical Nutritional Approach for Non-Dialysis CKD

Bellizzi

Carrero

Chauveau

et al. 2016

Nephrology @ Point of Care

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This is a case report on a patient with non-dialysis chronic kidney disease (CKD) in whom several nutritional issues are briefly discussed from a practical point of view. The article is accompanied by an editorial published in this Journal in relation to the 2 nd International Conference of the European Renal Nutrition working group at ERA-EDTA-"Retarding CKD progression: readily available through comprehensive nutritional management?"-and focuses on several practical topics associated with the nutritional approach for the conservative treatment of non-dialysis CKD. The article is divided into 3 sections-basic nutritional assessment, nutritional targets, and nutritional follow-up in non-dialysis CKD-linked to 3 consecutive steps of the clinical follow-up of the patient and the related nutritional concerns and intervention. First visit: Baseline nutritional assessment and basic nutritional considerations in non-dialysis chronic kidney disease (CKD)• What nutritional assessment/monitoring for protein-energy wasting (PEW) should be employed?• Is a body mass index (BMI) of 21 kg/m 2 adequate? • What phosphate target should be pursued?• What are the nutritional habits in patients with incident CKD?• What protein needs and amount of dietary protein should be pursued?• Does the quality of protein matter?• What amount of dietary salt should be employed? How should this be obtained?• How should normal serum phosphate be achieved?• What diet should be recommended? Is a vegetarian diet an option?

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“…Daily sodium intake is usually high and averages 10 g/day, mostly from discretionary sources [4,5,7]. …”

Section: Introductionmentioning

confidence: 99%

Eating Like a Rainbow: The Development of a Visual Aid for Nutritional Treatment of CKD Patients. A South African Project

Verseput¹,

Piccoli

2017

Nutrients

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Providing nutritional education for chronic kidney disease (CKD) patients in South Africa is complicated by several conditions: the population is composed of diverse ethnic groups, each with its own culture and food preferences; eleven languages are spoken and illiteracy is common in the lower socio-economic groups. Food preparation and storage are affected by the lack of electricity and refrigeration, and this contributes to a monotonous diet. In traditional African culture, two meals per day are often shared “from the pot”, making portion control difficult. There is both under- and over-nutrition; late referral of CKD is common. Good quality protein intake is often insufficient and there are several misconceptions about protein sources. There is a low intake of vegetables and fruit, while daily sodium intake is high, averaging 10 g/day, mostly from discretionary sources. On this background, we would like to describe the development of a simplified, visual approach to the “renal diet”, principally addressed to illiterate/non-English speaking CKD patients in Southern Africa, using illustrations to replace writing. This tool “Five steps to improve renal diet compliance”, also called “Eating like a Rainbow”, was developed to try to increase patients’ understanding, and has so far only been informally validated by feedback from users. The interest of this study is based on underlining the feasibility of dietary education even in difficult populations, focusing attention on this fundamental issue of CKD care in particular in countries with limited access to chronic dialysis.

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A practical approach to the nutritional management of chronic kidney disease patients in Cape Town, South Africa

Cited by 16 publications

References 18 publications

‘Let food be thy medicine…’: lessons from low-protein diets from around the world

‘Let food be thy medicine…’: lessons from low-protein diets from around the world

Retarding Chronic Kidney Disease (CKD) Progression: A Practical Nutritional Approach for Non-Dialysis CKD

Eating Like a Rainbow: The Development of a Visual Aid for Nutritional Treatment of CKD Patients. A South African Project

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