Protein Counting as an Educational Strategy to Optimize Low-Protein-Diet Adherence and Satisfaction in Stage 4 and 5 Chronic Kidney Disease Patients: A Pilot Study.

BACKGROUND/

OBJECTIVES

Educational support is a well-established strategy in diet management for chronic diseases. No study has reported the impact of protein counting in a low-protein diet for chronic kidney disease (CKD). We aimed to assess how a protein-counting educational program could enhance adherence and satisfaction in managing a low-protein diet in CKD patients with an eGFR below 20 mL/min/1.73 m2.

METHODS

We conducted a prospective pilot study comparing adherence and satisfaction before and after an educational program, which included four group meetings and two individual meetings over six months. Diet adherence was assessed by estimating protein intake using 24 h urine urea excretion, while diet satisfaction was evaluated with the MDRD questionnaire.

RESULTS

Twenty-four patients with a mean age of 63.9 years experienced improved diet adherence, with a significant reduction in protein intake (from 59.82 ± 15.57 g/day to 47.18 ± 13.7 g/day, p < 0.001) and a significant increase in overall diet satisfaction (from a median of 3.57 (3.1-4) to 4 (3.6-4.1), p = 0.001).

CONCLUSIONS

An educational program that includes protein counting assists CKD stage 4-5 patients in improving their diet adherence and increasing overall dietary satisfaction.