Menu suggestion: an effective way to improve dietary compliance in peritoneal dialysis patients

Abstract

Objective: Poor compliance with the dietary prescriptions is quite common in dialysis patients. We believe that most of the noncompliance is caused by the patient's poor understanding of the dietary prescription. Therefore, in the present study, we tried to investigate the role of menu suggestion in improving the patient's compliance with the dietary prescription.

Design and setting: A longitudinal cohort study conducted at an outpatient dialysis clinic.

Patients: Seventy clinically stable patients on peritoneal dialysis were included in this prospective study during April 1, 2004, to November 31, 2004, in a single center. Patients who had significant cognitive impairment and thus did not understand the food contents during the training course were not eligible for enrollment.

Intervention: All the patients were randomly assigned to 1 of 2 groups. Group 1 patients received the traditional patient education method. Group 2 patients additionally received individualized menu suggestions based on their food preferences and education on how to exchange the foods at equivalent amounts according to the exchange list.

Main outcome measures: At present, there are no clear optimal dietary protein intake levels for peritoneal dialysis patients. Our experience is that a dietary protein intake level of 0.8 to 1.2 g/kg/d can maintain our patients in a good nutritional status. Thereafter, in this study we prescribed the dietary protein intake level at 0.8 to 1.2 g/kg/d and defined compliance as meeting this target protein intake level.

Results: There were 35 patients in each group. The compliance was 22.9% in group 1 and 57.1% in group 2 (P < .05).

Conclusions: Our study suggests that menu suggestion may be an effective way of improving the compliance with the diet in peritoneal dialysis patients. It improves the patient's understanding of the dietary prescription.