Effects Of Individualized Diet Management On Patients With Non-dialysis Chronic Kidney Disease

ObjectiveTo study the effects of individual diet management on self-management ability,diet compliance,nutrition status and related biochemical indicators of patients with chronic kidney disease.MethodsThe study was designed as a quasi-experiment.101 no-dialysis patients with chronic kidney disease who conformed to standards and were included in the first and second departments of a third-grade grade a hospital in Hunan from April 2019 to August 2019 were selected as the study objects.Patients in the first department were identified as the experimental group(51 cases)and the second department as the control group(50 cases)by the random number table method.The control group adopted routine diet education,and the experimental group adopted individualized diet management,that is,assessment of patients’condition,nutritional status,dietary structure,dietary habits,economic status,etc.,developed phased individualized diet management for patients by using diet management system,and carried out COX health behavior interaction model throughout the whole process of evaluation,education,follow-up and feedback.Before the intervention,6 months after hospital discharge,use"chronic kidney disease self-management scale","kidney diet adherence attitude scale","kidney diet adherence scale","Modified quantitative Subjective Global Assessment,MQSGA"the measurement of the self-management ability,diet adherence,eating behavior and nutrition status,and collect the patient’s body measurements and blood biochemical examination results.The SPSS24.0statistical software was used to share the data.Mean±standard deviation(_x±_s),interquartile range,frequency and composition ratio were used for statistical description.Statistical analysis:chi-square test for qualitative data,t-test for quantitative data with two independent samples and non-parametric test.The test level wasa=0.05.Results(1)There was no significant difference in the general demographic data,clinical data,pre-intervention subjective nutrition assessment scale score,CKD self-management ability score,CKD diet compliance score,anthropometric indicators and related biochemical indicators between the two groups(P>0.05).(2)Comparison of nutritional status between the two groups:The incidence of malnutrition in the experimental group(11.75%)was sharply inferior to that in the control group(28%)after the intervention,and there was a statistically significant difference in nutritional status between the two groups(t=4.191,P=0.041);(3)Comparison of the self-management ability of the two groups of patients:After the intervention,the self-management ability of patients in the experimental group basically reached the upper-middle level,which was obviously superior to the control group(88%),the self-management ability was obvious difference between two groups(c~2=8.26,P=0.016).(4)Comparison of diet compliance between the two groups of patients:Using the non-parametric Mann-Whitney U test,the RAAQ score[79(79.67,80.16)]and the RABQ score[79(78.39,79.72)]in the experimental group were obviously superior to the control group[73(73.06,75.58);71(70.55,72.77)].The RAAQ and RABQ scores of the two groups were significantly different(Z=-6.642,P=0.000;Z=-7.662,P=0.000);(5)Comparison of anthropometric indexes between the two groups of patients:The independent two-sample t-test showed that the waist-hip ratio(0.825±0.058)and visceral index(7.124±2.387)of the experimental group obviously below the control group(0.870±0.081;8.155±2.505).There were significant differences in waist-to-hip ratio(t=-3.147,P=0.002)and visceral index(t=-2.118,P=0.037)between the two groups of patients;(6)Comparison of related biochemical indicators between the two groups of patients:The independent two-sample t test and non-parametric Mann-Whitney U test showed that serum prealbumin,serum albumin,triglyceride,and uric acid were significantly improved in the experimental group compared with the control group.The difference of Serum prealbumin(t=2.630,P=0.010),serum albumin(t=2.288,P=0.024),triglycerides(Z=3.047,P=0.002),uric acid(Z=2.955,P=0.003)in both groups was sharply significant.Conclusion:Individualized diet management can effectively improve the self-management ability and diet compliance of patients with non-dialysis chronic kidney disease,promote their formation of good eating habits,and improve nutritional status and blood lipid levels.