המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-10 16:56:40 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) – For patients with end-stage renal disease, adherence to standard lipid-lowering dietary guidelines on top of an already complex dialysis diet is difficult and does not lead to significant improvement in dyslipidemia, study results show. In this setting, pharmacologic therapy may be indicated.
Australian investigators led by Dr. David Saltissi of Royal Brisbane Hospital in Herston report the finding in the American Journal of Kidney Diseases for June. His team studied the effect of superimposing Australian National Heart Foundation lipid-lowering dietary recommendations on a typical dialysis diet over 14 weeks in 41 stable hemodialysis patients and 26 stable chronic peritoneal dialysis patients.
Problems with compliance were evident by 6 weeks, they report, and "in the final analysis, the only nutritional change to approach statistical significance was an 18% reduction in saturated fat intake in the hemodialysis group."
Dr. Saltissi and colleagues express concern in the paper that energy intake decreased by almost 10%, noting that suboptimal energy intake is associated with poor survival in chronic hemodialysis patients.
Moreover, only 24.4% of hemodialysis patients and 15.4% of peritoneal dialysis patients had a normalization of lipid levels.
The investigators conclude, based on the study, 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."
The findings also indicate, they add, that "the vast majority of dyslipidemic patients with end-stage renal failure require pharmacological therapy."
Am J Kidney Dis 2001;37:1209-1215.
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