Dietary Supplementation To Control Malnutrition in Chronic Hemodialysis Egyptian Patients

Abstract

End-stage renal disease (ESRD) is one of the main health problems in Egypt, and maintenance hemodialysis (MHD) represents the main mode for its treatment. Many factors lead to serious nutritional complications for MHD patients, including hyperphosphatemia and hypocalcemia, which affect the prognosis and quality of life of patients. Dietary management is an essential component to improve these nutritional complications. The aim of the present study was to find a suitable dietary intervention to improve hyperphosphatemia and hypocalcemia in patients on maintenance-hemodialysis. These interventions should be simple, easily applied, related to Egyptian diets, and the patients could adhere to them. Subjects: Twenty-one patients on MHD were selected from El- Doaah and El Rayan hospitals, Cairo, Egypt. All patients were under treatments according to the dialysis units. Twelve patients were first advised to adhere to a simple diet, for 4 months, on the 5th month, 9 patients were included, and all patients received the diet + 2 cups of green tea/day, for 4 months. 7-Summary 135 The dietary system included three daily meals in addition to snacks, based on Food composition tables for Egypt, second edition, (2006) by the National Nutrition Institute staff. The diets were mainly plant-based, and their constituents and amounts varied according to the patients’ weight and preference for specific foods. Blood samples were taken at baseline and monthly from all patients. Methods: Blood parameters studied included: Hemoglobin and serum urea, creatinine, phosphorous, and calcium. Statistical Analysis: The study design and complex aim call for different ways of statistical analysis that allow to compare not only effects of diets, but also to compare effects with respect to the baseline of each subject individually. The reference change value, defined as the critical differences that must be exceeded between two sequential results for a significant (or true) change to occur were calculated.