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6-tips diet: a simplified dietary approach in patients with chronic renal disease. A clinical randomized trial

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Abstract

Background

The beneficial effects of dietary restriction of proteins in chronic kidney disease are widely recognized; however, poor compliance to prescribed low-protein diets (LPD) may limit their effectiveness. To help patients to adhere to the dietary prescriptions, interventions as education programmes and dietary counselling are critical, but it is also important to develop simple and attractive approaches to the LPD, especially when dietitians are not available. Therefore, we elaborated a simplified and easy to manage dietary approach consisting of 6 tips (6-tip diet, 6-TD) which could replace the standard, non-individualized LPD in Nephrology Units where dietary counselling is not available; hence, our working hypothesis was to evaluate the effects of such diet vs a standard moderately protein-restricted diet on metabolic parameters and patients’ adherence.

Methods

In this randomized trial, 57 CKD patients stage 3b-5 were randomly assigned (1:1) to receive the 6-TD (Group 6-TD) or a LPD containing 0.8 g/kg/day of proteins (Group LPD) for 6 months. The primary endpoint was to evaluate the effects of the two different diets on the main “metabolic” parameters and on patients’ adherence (registration number NCT01865526).

Results

Both dietary regimens were associated with a progressive reduction in protein intake and urinary urea excretion compared to baseline, although the decrease was more pronounced in Group 6-TD. Effects on serum levels of urea nitrogen and urinary phosphate excretion were greater in Group 6-TD. Plasma levels of phosphate, bicarbonate and PTH, and urinary NaCl excretion remained stable in both groups throughout the study. 44 % of LPD patients were adherent to the dietary prescription vs 70 % of Group 6-TD.

Conclusions

A simplified diet, consisting of 6 clear points easily managed by CKD patients, produced beneficial effects either on the metabolic profile of renal disease and on patients’ adherence to the dietary plan, when compared to a standard LPD.

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Author notes

    Authors and Affiliations

    1. Chair of Nephrology, Department of Public Health, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy

      Antonio Pisani, Eleonora Riccio, Giusi Mozzillo, Marco Amato, Bruno Cianciaruso & Massimo Sabbatini

    2. Division of Nephrology, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy

      Vincenzo Bellizzi

    3. Division of Nephrology, Hospital “U. Parini”, Aosta, Italy

      Donatella Luciana Caputo

    4. Division of Nephrology, University “Magna Graecia”, Catanzaro, Italy

      Michele Andreucci

    Authors
    1. Antonio Pisani
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    2. Eleonora Riccio
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    3. Vincenzo Bellizzi
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    4. Donatella Luciana Caputo
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    5. Giusi Mozzillo
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    6. Marco Amato
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    7. Michele Andreucci
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    8. Bruno Cianciaruso
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    9. Massimo Sabbatini
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    Correspondence to Eleonora Riccio.

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    All the authors declare that no conflict of interest exists.

    Additional information

    A. Pisani and E. Riccio contributed equally to this work.

    Deceased: B. Cianciaruso.

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    Pisani, A., Riccio, E., Bellizzi, V. et al. 6-tips diet: a simplified dietary approach in patients with chronic renal disease. A clinical randomized trial. Clin Exp Nephrol 20, 433–442 (2016). https://doi.org/10.1007/s10157-015-1172-5

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    • DOI: https://doi.org/10.1007/s10157-015-1172-5

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