Quality of Life in CKD Patients on Low-Protein Diets in a Multiple-Choice Diet System. Comparison between a French and an Italian Experience

Abstract

Prescribing a low-protein diet (LPD) is part of the standard management of patients in advanced stages of chronic kidney disease (CKD). However, studies on the quality of life (QoL) of patients on LPDs are lacking, and the impact these diets have on their QoL is often given as a reason for not prescribing one. We, therefore, decided to assess the QoL in a cohort of CKD stage 3–5 patients followed up by a multiple-choice diet approach in an outpatient nephrology clinic in France. To do so, we used the short version of the World Health Organization’s quality of life questionnaire and compared the results with a historical cohort of Italian patients. We enrolled 153 patients, managed with tailored protein restriction in Le Mans, and compared them with 128 patients on similar diets who had been followed in Turin (Italy). We found there were no significant differences in terms of age (median 73 vs. 74 years, respectively), gender, CKD stage, and comorbidities (Charlson’s Comorbidity Index 7 vs. 6). French patients displayed a greater body mass index (29.0 vs. 25.4, p < 0.001) and prevalence of obesity (41.2 vs. 15.0%, p < 0.001). Baseline protein intake was over the target in France (1.2 g/kg of real body weight/day). In both cohorts, the burden of comorbidities was associated with poorer physical health perception while kidney function was inversely correlated to satisfaction with social life, independently of the type of diet. Our study suggests that the type of LPD they follow does not influence QoL in CKD patients and that a personalized approach towards protein restriction is feasible, even in elderly patients.

Impact of Hospitalization on the Quality of Life of Patients with Chronic Kidney Disease in Saudi Arabia

“…The association of the demographic variables with the KDQOL demonstrated that an increase in the age of the patients decreased their QoL; this was a significant association in OPD patients in this study ( p < 0.0001). It has also been identified that older patients have much poorer physical functioning scores [ 32 , 33 ]. Considering the gender variable, male patients had a lower QoL than the female patients in both the IPD and OPD groups; this was highly significant ( p < 0.0001).…”

Incremental and Personalized Hemodialysis Start: A New Standard of Care

“…Detailed follow-up schedules are available elsewhere; these include, for chronic kidney disease stage 5 or fragile patients with rapidly deteriorating kidney function, 1 to 4 consultations per month, usually with concomitant blood tests. 36 …”

Spontaneous low-protein intake in older CKD patients: one diet may not fit all

“…sLPI patients, were generally older (80 ± 8 vs. 75 ± 14, p = 0.017) and has a higher prevalence of frailty [24, (33%) vs. 12, (24%), p = 0.037]. These patients also had markedly worse renal function parameters, such as lower eGFR (18 [13][14][15][16][17][18][19][20][21][22][23] vs. 28 [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38], p < 0.0001), creatinine clearance (18[14-23.5] vs. 39[23-46], p < 0.0001) and higher serum urea (107[83-132] vs. 80[67-119], p = 0.04). No differences in terms of sex and diabetes prevalence were observed.…”