N OBEID1, T PIANTA1, D LANGSFORD1, J WILLCOX2
1Northern Health, Melbourne, Australia, 2LaTrobe University, Melbourne, Australia
Aim: To observe the safety of a 12 week Low Calorie Diet (LCD) and its effectiveness in achieving weight loss and body composition change in dialysis patients requiring weight loss for kidney transplant eligibility.
Background: LCDs including meal replacement products achieve significant weight loss results, however there is limited evidence examining safety with dialysis patients or effect on body composition.
Methods: Prospective, pilot, open-label study of 5 participants prescribed a 12 week LCD incorporating 3 meal replacement products, 100g lean meat, 2 cups low-potassium, low-starch vegetables and 5mL oil daily (3.6MJ, 90g protein). Measures of safety (blood pressure, dialysis parameters, biochemistry, and medications) and effectiveness (dry weight after adjustment for over-hydration, fat mass and lean tissue mass with Fresenius Medical Care Body Composition Monitor) were monitored.
Results: Six participants were recruited, one self-withdrew, five completed the trial (mean 56 years [range 49 – 61 years], 4 male 1 female, mean BMI 40kg/m2 [30.6 – 47.9kg/m2]). Two required hospital admissions (fluid overload and atrial fibrillation) and three experienced hyperkalaemia (K+ 6.0 – 6.6mmol/L) but medical assessment deemed unrelated to prescribed diet. All achieved a reduction in dry weight [mean -4.5% (-2.0 to -9.3%)]. Change in fat mass [mean +1.2% (-14% to +21.1%)] and lean tissue mass [mean -8.8% (-29% to +2.9%)] varied. Dietary adherence varied between participants but related to greater fat and lower lean tissue loss.
Conclusions: Despite variable adherence, LCD appeared safe in dialysis patients. Further research is required to optimise LCD models, adherence and body composition outcomes.
Nadia has been working as a Dietitian for 12 years and is currently working in the renal service at Northern Health in Victoria Australia. Throughout her career she has undertaken numerous quality and research projects. Some of her research work includes creating culturally appropriate nutrition education materials for Arabic women with gestational diabetes, and providing dialysis patients with a low calorie diet plan to help them to lose weight to meet eligibility criteria for kidney transplantation waitlisting.