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Kidney Week

Abstract: PO2029

Benefits of Home-Delivered, Low-Sodium Meals in Hemodialysis Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Perez, Luis M., University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Fang, Hsin-Yu, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Burrows, Brett, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • King, Alexis, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Ashrafi, Sadia anjum, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Wilund, Kenneth Robert, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States

Group or Team Name

  • Renal and Cardiovascular Research Laboratory
Background

Patients undergoing maintenance hemodialysis (HD) therapy are routinely counseled to reduce dietary sodium intake to reduce sodium retention, volume overload (VO), and hypertension. Unfortunately, low-sodium trials in HD are sparse and mostly indicate that dietary education and behavioral counseling alone are ineffective in reducing sodium intake. The purpose of this study is to determine if 4-weeks of a low-sodium home delivered meals intervention will reduce interdialytic weight gain (IDWG) and subsequent VO and hypertension in patients undergoing HD when compared to 4-weeks of a usual diet.

Methods

We recruited 20 subjects (55+12 years, BMI 40.7+16.6 kg/m^2, 45% male, 65% AA, 70% DM, 50% CVD) from a HD clinic in central IL. Participants followed a usual-control diet for the first 4-weeks. PurFoods, LLC prepared and shipped 3 low-sodium kidney meals (<700 mg sodium, potassium, and phosphorus each) per day to patients in the following 4-weeks. We collected monthly IDWG, bioelectrical impedance, standardized blood pressure, 3 days (HD, non-HD, and weekend day) of dietary recalls, and blood at baseline (0M), after a usual diet (1M), and post-intervention meals (2M).

Results

Home-meal delivery significantly reduced both dietary sodium intake, IDWG, systolic blood pressure (SBP), and diastolic blood pressure (DBP) (Table). These changes were accompanied by reductions in total body water (TBW) and calculated VO (Table). These changes were mostly driven by reductions at 2M, except for a significant increase in IDWG from 0M to 1M (p < 0.05).

Conclusion

Low-sodium home-meal delivery appears to be an effective method to reduce dietary sodium intake, IDWG, BP, and VO in HD patients. It will be important determine if these changes can be sustained long-term with additional counseling and in larger sample sizes. The long-term benefits and cost-effectiveness of this approach also needs to be evaluated.

Changes in Volume-Related Parameters
Variable (mean ± SD)0M1M2MP-value
Dietary sodium, mg3603 ± 13413640 ± 13581890 ± 360< 0.01
IDWG, kg2.9 ± 1.23.2 ± 1.12.4 ± 1.1< 0.01
TBW, L56.5 ± 15.358.3 ± 13.554.3 ± 11.8< 0.05
VO, L2.9 ± 4.92.9 ± 5.11.9 ± 4.6< 0.05
SBP, mmHg161 ± 18161 ± 24143 ± 18< 0.01
DBP, mmHg91 ± 1388 ± 1182 ± 14< 0.01

Funding

  • Commercial Support