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Psychological Aspects and Patients Compliance to Restricted-protein Regimens in Chronic Kidney Disease

Conditions
Psychological Characteristics Involved in Dietary Compliance
Registration Number
NCT02345759
Lead Sponsor
Anemia Working Group Romania
Brief Summary

Dietary management of CKD patients proved important to postpone dialysis. Long-term compliance to protein-restricted diets was discussed. Psychological aspects involved in certain dietary behaviour have never been studied.

Detailed Description

The interest in dietary management resurged, since the high prevalence of revealed a major impact not only on morbidity, mortality, social activities and patients' quality of life, but also on health budget.

Although protein-restricted diets are used for more than a century in patients with advanced Chronic Kidney Disease (CKD), their efficacy and safety is still debatable. Enough evidence has being accumulated on their role in postponing dialysis initiation in compliant patients. Consequently, the long-term compliance to the diet is discussed. Psychological aspects of compliant patients are certainly involved. Identification of certain psychological predictors of dietary compliance could help to select the patients who are more likely to be compliant and therefore to benefit from such an intervention. Moreover, short-term or long-term psychological intervention addressing these factors could increase patient long-term compliance.

Accordingly, we are aiming to evaluate psychological characteristics of Chronic Kidney Disease patients in relation with their compliance to protein-restricted regimens.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
120
Inclusion Criteria
  • adult patients
  • stage 4+ CKD
  • good nutritional status (Subjective Global Assessment score A/B and serum albumin ≥3.5 g/dL)
  • declared potentially good compliance with a low protein diet and agreed to follow the monitoring schedule are considered for the program
Exclusion Criteria
  • poorly controlled arterial blood pressure (≥145/85 mm Hg)
  • uncontrolled diabetes mellitus
  • other relevant comorbidities (heart failure, active hepatic disease, digestive diseases with malabsorption, inflammation/anti-inflammatory therapy)
  • uremic complications (pericarditis, polyneuropathy)
  • feeding inability (anorexia, nausea)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Compliance to the protein-restricted diet12 months

The compliance to the diet is appreciated to be good if both the achieved protein intake and the achieved energy is in the range of ±10% of the recommended values.

Secondary Outcome Measures
NameTimeMethod
Nitrogen balance (Serum urea level)12 months

Serum urea level

Parameters related to renal function (The decline in glomerular filtration rate (GFR) GFR decline12 months

The decline in glomerular filtration rate (GFR)

Psychological parameter - self-efficacy score12 months

Self-efficacy score derives from the self-efficacy scale.

Metabolic acidosis (Serum bicarbonate level)12 months

Serum bicarbonate level

Calcium-phosphorus metabolism abnormalities (Serum calcium)12 months

Serum calcium

Calcium-phosphorus metabolism abnormalities (Serum phosphates level)12 months

Serum phosphates level

Psychological parameter - illness perception (Sub-scores derived from illness perception questionnaire)12 months

Sub-scores derived from illness perception questionnaire: the higher this score, the worse is patient's perception on the disease.

Mental status - vitality index12 months

Vitality score derived from mental component of SF-36

Psychological parameter -mental score12 months

The mental score looks at depression. Psychological difficulties interfere with the initiation of compliance behaviours.

Trial Locations

Locations (1)

Spitalul Clinic de Nefrologie "Dr Carol Davila"

🇷🇴

Bucuresti, Romania

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