Effect of lipid-lowering dietary recommendations on the nutritional intake and lipid profiles of chronic peritoneal dialysis and hemodialysis patients
Patients with end-stage renal failure are a high-risk group for atherosclerotic cardiovascular disease and commonly have dyslipidemia as a major factor. Dietary manipulation is the recommended first line of therapy for reducing lipid levels in people with normal renal function; however, complex diet...
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| Veröffentlicht in: | American journal of kidney diseases 2001-06, Vol.37 (6), p.1209-1215 |
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| creator | Saltissi, David Morgan, Colleen Knight, Brigid Chang, Wendy Rigby, Russell Westhuyzen, Justin |
| description | Patients with end-stage renal failure are a high-risk group for atherosclerotic cardiovascular disease and commonly have dyslipidemia as a major factor. Dietary manipulation is the recommended first line of therapy for reducing lipid levels in people with normal renal function; however, complex dietary requirements of dialysis-treated patients with end-stage renal failure impose significant constraints. In this study, we evaluated the effect of trying to comply with established lipid-lowering recommendations superimposed on our normally prescribed dialysis diet over 14 weeks in stable subjects treated with either hemodialysis (HD) or chronic peritoneal dialysis (PD). Of 306 dialysis patients screened, 75 subjects were enrolled; 8 subjects did not complete the study. In the remainder, HD subjects (n [equals] 41) decreased saturated fat intakes by 18[percnt] overall and cholesterol intakes by 16[percnt]. This was associated with a decrease in total cholesterol levels from 232 [plusmn] 8 to 209 [plusmn] 4 mg[sol ]dL (mean [plusmn] SEM; P [equals] 0.007) and low-density lipoprotein cholesterol levels from 147 [plusmn] 4 to 131 [plusmn] 4 mg[sol ]dL (P [equals] 0.009). However, energy intakes decreased by almost 10[percnt]. There were no statistically significant changes in PD patients (n [equals] 26). Only 24.4[percnt] of HD (10 of 41 patients) and 15.4[percnt] of PD patients (4 of 26 patients) normalized their lipid levels. Considerable problems were encountered in maintaining compliance with the modified dialysis diets. This study shows that if adhered to, properly constructed dialysis diets are close to optimal lipid-lowering recommendations. Further dietary manipulation is difficult, leads to little benefit in the majority, and is accompanied by added problems of adherence. We conclude that the vast majority of dyslipidemic patients with end-stage renal failure require pharmacological therapy. |
| doi_str_mv | 10.1053/ajkd.2001.24524 |
| format | Article |
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Dietary manipulation is the recommended first line of therapy for reducing lipid levels in people with normal renal function; however, complex dietary requirements of dialysis-treated patients with end-stage renal failure impose significant constraints. In this study, we evaluated the effect of trying to comply with established lipid-lowering recommendations superimposed on our normally prescribed dialysis diet over 14 weeks in stable subjects treated with either hemodialysis (HD) or chronic peritoneal dialysis (PD). Of 306 dialysis patients screened, 75 subjects were enrolled; 8 subjects did not complete the study. In the remainder, HD subjects (n [equals] 41) decreased saturated fat intakes by 18[percnt] overall and cholesterol intakes by 16[percnt]. This was associated with a decrease in total cholesterol levels from 232 [plusmn] 8 to 209 [plusmn] 4 mg[sol ]dL (mean [plusmn] SEM; P [equals] 0.007) and low-density lipoprotein cholesterol levels from 147 [plusmn] 4 to 131 [plusmn] 4 mg[sol ]dL (P [equals] 0.009). However, energy intakes decreased by almost 10[percnt]. There were no statistically significant changes in PD patients (n [equals] 26). Only 24.4[percnt] of HD (10 of 41 patients) and 15.4[percnt] of PD patients (4 of 26 patients) normalized their lipid levels. Considerable problems were encountered in maintaining compliance with the modified dialysis diets. This study shows that if adhered to, properly constructed dialysis diets are close to optimal lipid-lowering recommendations. Further dietary manipulation is difficult, leads to little benefit in the majority, and is accompanied by added problems of adherence. 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Dialysis management ; Energy Intake - drug effects ; Fats - metabolism ; Female ; Humans ; Hyperlipidemias - diet therapy ; Hyperlipidemias - therapy ; Intensive care medicine ; Kidney Failure, Chronic - diet therapy ; Kidney Failure, Chronic - therapy ; Lipid Metabolism ; Male ; Medical sciences ; Middle Aged ; Patient Dropouts ; Peritoneal Dialysis ; Proteins - drug effects ; Proteins - metabolism ; Renal Dialysis ; Treatment Outcome</subject><ispartof>American journal of kidney diseases, 2001-06, Vol.37 (6), p.1209-1215</ispartof><rights>2001 The National Kidney Foundation, Inc.</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-cb535c573f031785d66bbba4825f4fa5ba02ec526fec0405188dbdfab07ab8c13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/ajkd.2001.24524$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1003462$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11382690$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saltissi, David</creatorcontrib><creatorcontrib>Morgan, Colleen</creatorcontrib><creatorcontrib>Knight, Brigid</creatorcontrib><creatorcontrib>Chang, Wendy</creatorcontrib><creatorcontrib>Rigby, Russell</creatorcontrib><creatorcontrib>Westhuyzen, Justin</creatorcontrib><title>Effect of lipid-lowering dietary recommendations on the nutritional intake and lipid profiles of chronic peritoneal dialysis and hemodialysis patients</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Patients with end-stage renal failure are a high-risk group for atherosclerotic cardiovascular disease and commonly have dyslipidemia as a major factor. Dietary manipulation is the recommended first line of therapy for reducing lipid levels in people with normal renal function; however, complex dietary requirements of dialysis-treated patients with end-stage renal failure impose significant constraints. In this study, we evaluated the effect of trying to comply with established lipid-lowering recommendations superimposed on our normally prescribed dialysis diet over 14 weeks in stable subjects treated with either hemodialysis (HD) or chronic peritoneal dialysis (PD). Of 306 dialysis patients screened, 75 subjects were enrolled; 8 subjects did not complete the study. In the remainder, HD subjects (n [equals] 41) decreased saturated fat intakes by 18[percnt] overall and cholesterol intakes by 16[percnt]. This was associated with a decrease in total cholesterol levels from 232 [plusmn] 8 to 209 [plusmn] 4 mg[sol ]dL (mean [plusmn] SEM; P [equals] 0.007) and low-density lipoprotein cholesterol levels from 147 [plusmn] 4 to 131 [plusmn] 4 mg[sol ]dL (P [equals] 0.009). However, energy intakes decreased by almost 10[percnt]. There were no statistically significant changes in PD patients (n [equals] 26). Only 24.4[percnt] of HD (10 of 41 patients) and 15.4[percnt] of PD patients (4 of 26 patients) normalized their lipid levels. Considerable problems were encountered in maintaining compliance with the modified dialysis diets. This study shows that if adhered to, properly constructed dialysis diets are close to optimal lipid-lowering recommendations. Further dietary manipulation is difficult, leads to little benefit in the majority, and is accompanied by added problems of adherence. We conclude that the vast majority of dyslipidemic patients with end-stage renal failure require pharmacological therapy.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>Carbohydrate Metabolism</subject><subject>Dietary Fats - administration & dosage</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Energy Intake - drug effects</subject><subject>Fats - metabolism</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperlipidemias - diet therapy</subject><subject>Hyperlipidemias - therapy</subject><subject>Intensive care medicine</subject><subject>Kidney Failure, Chronic - diet therapy</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Lipid Metabolism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Dropouts</subject><subject>Peritoneal Dialysis</subject><subject>Proteins - drug effects</subject><subject>Proteins - metabolism</subject><subject>Renal Dialysis</subject><subject>Treatment Outcome</subject><issn>0272-6386</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kb1uFDEUhS0EIkugpkMuULrZ-Gfs8ZYoSgApEg3Ulse-Zp3M2IPtJcqL8Lx4siugobJ09Z3je89B6C0lW0oEvzR3927LCKFb1gvWP0MbKhjvpOLqOdoQNrBOciXP0KtS7gghOy7lS3RGKVdM7sgG_br2HmzFyeMpLMF1U3qAHOJ37AJUkx9xBpvmGaIzNaRYcIq47gHHQ81hnZgJh1jNPWAT3dEELzn5MEFZbe0-pxgsXpptTREa74KZHksoT4o9zOnPYGmfQKzlNXrhzVTgzek9R99urr9efepuv3z8fPXhtrM9V7Wzo-DCioF7wumghJNyHEfTKyZ8740YDWFgBZPtRtITQZVyo_NmJIMZlaX8HF0cfdvGPw5Qqp5DsTBNJkI6FD2QXdMw0cDLI2hzKiWD10sOc8tHU6LXKvRahV6r0E9VNMW7k_VhnMH95U_ZN-D9CTDFmslnE20o__gS3kvWsN0Rg5bDzwBZF9sysuBCq6Zql8J_d_gNUHupow</recordid><startdate>20010601</startdate><enddate>20010601</enddate><creator>Saltissi, David</creator><creator>Morgan, Colleen</creator><creator>Knight, Brigid</creator><creator>Chang, Wendy</creator><creator>Rigby, Russell</creator><creator>Westhuyzen, Justin</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010601</creationdate><title>Effect of lipid-lowering dietary recommendations on the nutritional intake and lipid profiles of chronic peritoneal dialysis and hemodialysis patients</title><author>Saltissi, David ; Morgan, Colleen ; Knight, Brigid ; Chang, Wendy ; Rigby, Russell ; Westhuyzen, Justin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-cb535c573f031785d66bbba4825f4fa5ba02ec526fec0405188dbdfab07ab8c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>Carbohydrate Metabolism</topic><topic>Dietary Fats - administration & dosage</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Energy Intake - drug effects</topic><topic>Fats - metabolism</topic><topic>Female</topic><topic>Humans</topic><topic>Hyperlipidemias - diet therapy</topic><topic>Hyperlipidemias - therapy</topic><topic>Intensive care medicine</topic><topic>Kidney Failure, Chronic - diet therapy</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Lipid Metabolism</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Dropouts</topic><topic>Peritoneal Dialysis</topic><topic>Proteins - drug effects</topic><topic>Proteins - metabolism</topic><topic>Renal Dialysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saltissi, David</creatorcontrib><creatorcontrib>Morgan, Colleen</creatorcontrib><creatorcontrib>Knight, Brigid</creatorcontrib><creatorcontrib>Chang, Wendy</creatorcontrib><creatorcontrib>Rigby, Russell</creatorcontrib><creatorcontrib>Westhuyzen, Justin</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saltissi, David</au><au>Morgan, Colleen</au><au>Knight, Brigid</au><au>Chang, Wendy</au><au>Rigby, Russell</au><au>Westhuyzen, Justin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of lipid-lowering dietary recommendations on the nutritional intake and lipid profiles of chronic peritoneal dialysis and hemodialysis patients</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2001-06-01</date><risdate>2001</risdate><volume>37</volume><issue>6</issue><spage>1209</spage><epage>1215</epage><pages>1209-1215</pages><issn>0272-6386</issn><eissn>1523-6838</eissn><abstract>Patients with end-stage renal failure are a high-risk group for atherosclerotic cardiovascular disease and commonly have dyslipidemia as a major factor. Dietary manipulation is the recommended first line of therapy for reducing lipid levels in people with normal renal function; however, complex dietary requirements of dialysis-treated patients with end-stage renal failure impose significant constraints. In this study, we evaluated the effect of trying to comply with established lipid-lowering recommendations superimposed on our normally prescribed dialysis diet over 14 weeks in stable subjects treated with either hemodialysis (HD) or chronic peritoneal dialysis (PD). Of 306 dialysis patients screened, 75 subjects were enrolled; 8 subjects did not complete the study. In the remainder, HD subjects (n [equals] 41) decreased saturated fat intakes by 18[percnt] overall and cholesterol intakes by 16[percnt]. This was associated with a decrease in total cholesterol levels from 232 [plusmn] 8 to 209 [plusmn] 4 mg[sol ]dL (mean [plusmn] SEM; P [equals] 0.007) and low-density lipoprotein cholesterol levels from 147 [plusmn] 4 to 131 [plusmn] 4 mg[sol ]dL (P [equals] 0.009). However, energy intakes decreased by almost 10[percnt]. There were no statistically significant changes in PD patients (n [equals] 26). Only 24.4[percnt] of HD (10 of 41 patients) and 15.4[percnt] of PD patients (4 of 26 patients) normalized their lipid levels. Considerable problems were encountered in maintaining compliance with the modified dialysis diets. This study shows that if adhered to, properly constructed dialysis diets are close to optimal lipid-lowering recommendations. Further dietary manipulation is difficult, leads to little benefit in the majority, and is accompanied by added problems of adherence. We conclude that the vast majority of dyslipidemic patients with end-stage renal failure require pharmacological therapy.</abstract><cop>Orlando, FL</cop><pub>Elsevier Inc</pub><pmid>11382690</pmid><doi>10.1053/ajkd.2001.24524</doi><tpages>7</tpages></addata></record> |
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| ispartof | American journal of kidney diseases, 2001-06, Vol.37 (6), p.1209-1215 |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Body Mass Index Carbohydrate Metabolism Dietary Fats - administration & dosage Emergency and intensive care: renal failure. Dialysis management Energy Intake - drug effects Fats - metabolism Female Humans Hyperlipidemias - diet therapy Hyperlipidemias - therapy Intensive care medicine Kidney Failure, Chronic - diet therapy Kidney Failure, Chronic - therapy Lipid Metabolism Male Medical sciences Middle Aged Patient Dropouts Peritoneal Dialysis Proteins - drug effects Proteins - metabolism Renal Dialysis Treatment Outcome |
| title | Effect of lipid-lowering dietary recommendations on the nutritional intake and lipid profiles of chronic peritoneal dialysis and hemodialysis patients |
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