A CROSS SECTIONAL STUDY OF NUTRITIONAL ASSESSMENT IN CHRONIC KIDNEY DISEASE PATIENTS.

Background: Chronic kidney disease is one of the global burdens, more so in developing countries where the medical facility is not abundantly available in the rural areas. Along with comorbid conditions, protein energy malnutrition plays a vital role in progression of renal disease. Proper diet management can decrease the rapid progression of chronic kidney disease. Though many studies have been done in other countries regarding the nutritional assessment in chronic kidney disease patients, it is mandatory to assess the prevalence of malnutrition in the rural or urban population of developing country. Methods: 100 consecutive patients were enrolled for the study. After obtaining written consent, history regarding the demographic data, duration of the disease, associated clinical features and 24 hour dietary recall were obtained. Then basic anthropometric parameters such as height, weight, Body Mass Index, skin fold thickness and mid arm circumference was measured. Later laboratory parameters such as haemoglobin, serum urea, serum creatinine, calcium, phosphorus, uric acid, total protein and serum albumin was measure. Results: The prevalence of protein energy malnutrition is 36% in our study which is more prevalent in the male gender as the total number of male patients are predominant in our study. And the patients in the initial stages of CKD are not aware of low protein diet. It is advisable to introduce dietary management along with medical management in all stages of chronic kidney disease patients. Conclusion: The incidence of PEM among the study population is nearly high but proper nutritional knowledge is lacking in these patients. Hence it is mandatory to introduce dietary management along with medical management in all stages of CKD so that rapid progression to end stage renal disease can be delayed.. It is also identified that severe protein energy malnutrition itself increases the mortlity of the patients. Small population, unequal gender and age distribution, shorter time period and unavailability of data for stage 1 CKD were the major limitations of the study. Hence in the future rectifying all the above said limitations such a study has to repeated periodically for better understanding of the study which will further improve the patient care and may help in reducing the early progression of the kidney disease.a large randomised control study can throw mucy light in the management of PEM in CKD patients.