Nutritional management of chronic renal failure by dietitians – the South African experience

Herselman, Marlien; Esau, Nazeema; Steel, K S; Allen, Nathan; Lang, N. P.

doi:10.1080/16070658.2005.11734041

Cited by 4 publications

(2 citation statements)

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“…Poor literacy and a shortage of renal dietitians/nutritionists pose further challenges for ensuring the adequacy of patients' dietary intakes in many countries in the SSA region. Even where dietitians are available, they are not enough of them [ 18 ] rendering nutrition care suboptimal in this region.…”

Section: Introductionmentioning

confidence: 99%

A Cross-Sectional Analysis of Dietary Intake and Nutritional Status of Patients on Haemodialysis Maintenance Therapy in a Country of Sub-Saharan Africa

Gityamwi

Hart

Engel

2021

International Journal of Nephrology

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Malnutrition is common among dialysis patients, but there is insufficient literature on the problem from resource-poor settings of the sub-Saharan region. We conducted a cross-sectional investigation of dietary intake and nutritional status of haemodialysis (HD) patients to inform the current status of this population group in the region. HD patients aged ≥18 years, with dialysis vintage of ≥3 months, at one nephrology unit in Tanzania were assessed for their habitual diet and nutrient intake. Anthropometric measures and biochemistry tests were also performed. The diet was predominantly starchy food based, accompanied by a limited selection of vegetables. Fruits and animal protein were also minimally consumed (1 portion/day each). Fruit consumption was higher in females than males (median (25th, 75th) = 2 (1, 2.3) versus 0.5 (0, 1.7) portions, p = 0.008). More than 70% of participants had suboptimal measures for protein and energy intake, dietary iron, serum albumin, muscle mass, and hand grip strength (HGS). Inadequacies in protein and energy intake and dialysis clearance (URR) increased with the increase in body weight/BMI and other specific components (MAMC and FMI). Consumption of red meats correlated significantly and positively with serum creatinine (r = 0.46, p = 0.01), potassium (r = 0.39, p = 0.03), and HGS (r = 0.43, p = 0.02) and was approaching significance for a correlation with serum iron (r = 0.32, p = 0.07). C-RP correlated negatively with albumin concentration (r = −0.32, p = 0.02), and participants with C-RP within acceptable ranges had significantly higher levels of haemoglobin ( p = 0.03, effect size = −0.28). URR correlated negatively with haemoglobin concentration (r = −0.36, p = 0.02). Patients will benefit from improved nutritional services that deliver individually tailored and culturally practical dietary advice to enable them to make informed food choices whilst optimizing disease management.

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Section: Introductionmentioning

confidence: 99%

A Cross-Sectional Analysis of Dietary Intake and Nutritional Status of Patients on Haemodialysis Maintenance Therapy in a Country of Sub-Saharan Africa

Gityamwi

Hart

Engel

2021

International Journal of Nephrology

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“…Even where dietitians may be available, a thorough knowledge of prescription of low protein diets or other dietary and nutritional education and counselling of patients may not be firmly established given that there are not a lot of research on diets and CKD in Africa. One study designed to assess the practices of South African dietitians regarding the dietary treatment of patients with CKD reported a low level of exposure of dietitians to renal patients (28 %) with substantial deviation from international standards reported in their prescriptions [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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

2016

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BackgroundThe multi-racial and multi-ethnic population of South Africa has significant variation in their nutritional habits with many black South Africans undergoing a nutritional transition to Western type diets. In this review, we describe our practical approaches to the dietary and nutritional management of chronic kidney disease (CKD) patients in Cape Town, South Africa.DiscussionDue to poverty and socio-economic constraints, significant challenges still exist with regard to achieving the nutritional needs and adequate dietary counselling of many CKD patients (pre-dialysis and dialysis) in South Africa. Inadequate workforce to meet the educational and counselling needs of patients, inability of many patients to effectively come to terms with changing body and metabolic needs due to ongoing kidney disease, issues of adherence to fluid and food restrictions as well as adherence to medications and in some cases the inability to obtain adequate daily food supplies make up some of these challenges. A multi-disciplinary approach (dietitians, nurses and nephrologists) of regularly reminding and educating patients on dietary (especially low protein diets) and nutritional needs is practiced. The South African Renal exchange list consisting of groups of food items with the same nutritional content has been developed as a practical tool to be used by dietitians to convert individualized nutritional prescriptions into meal plan to meet the nutritional needs of patients in South Africa. The list is currently utilized in counselling CKD patients and provides varied options for food items within the same group (exchangeable) as well as offering ease for the description of suitable meal portions (sizes) to our patients.SummaryRegular and continuous education of CKD patients by a multi-disciplinary team in South Africa enables our patients to meet their nutritional goals and retard CKD progression. The South African renal exchange list has proved to be a very useful tool in meeting this need.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0297-4) contains supplementary material, which is available to authorized users.

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Moving the Issue of Renal Dietitian Staffing Forward

Wolfe

2012

Journal of Renal Nutrition

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Nutritional management of chronic renal failure by dietitians – the South African experience

Cited by 4 publications

References 20 publications

A Cross-Sectional Analysis of Dietary Intake and Nutritional Status of Patients on Haemodialysis Maintenance Therapy in a Country of Sub-Saharan Africa

A Cross-Sectional Analysis of Dietary Intake and Nutritional Status of Patients on Haemodialysis Maintenance Therapy in a Country of Sub-Saharan Africa

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

Moving the Issue of Renal Dietitian Staffing Forward

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