The effectiveness of a combined nutritional management model in non-dialysis chronic kidney disease patients with hypertension
Objective To investigate the effect of a combined nutritional management by analyzing the relationship between rapid progression of chronic kidney disease(CKD),blood pressure control and nutritional management in patients with CKD.Methods A total of 238 non-dialysis CKD patients with hypertension who followed-up at the Department of Nephrology of the First Affiliated Hospital of Xiamen University for over one year from June 2019 to June 2022 were collected.According to taking part in the nutritional management or not,patients were divided into nutritional management group(138 cases)and traditional treatment group(100 cases).General characteristics,laboratory test results,blood pressure,and medication therapy between the two groups were compared.The corre-lations between rapid progression of CKD,blood pressure control,and nutritional management were analyzed using logistic regression model analysis.Results The nutritional management group exhibited a lower baseline age and estimated glomerular filtration rate(eGFR)(both P＜0.05).Compared with the traditional treatment group,the nutrition management group had a lower rate of rapid CKD progression and a higher blood pressure control rate(both P＜0.001),a larger systolic blood pressure decrease and a smaller annual eGFR decrease at the end of obser-vation(both P＜0.05).Albumin increased in the nutrition management group and decreased in the traditional treat-ment group,and the difference was statistically significant(P＜0.05).There were no statistically significant differ-ences between the two groups in terms of changes in hemoglobin,cholesterol,uric acid,blood potassium,and blood sodium(P＞0.05).Multivariate logistic regression analysis showed that after adjusting for gender,CKD etiology,body mass index changes,and other factors at baseline such as age,eGFR,systolic and diastolic blood pressure,clinical drug therapy,the incidence of rapid CKD progression was lower(OR=0.184,95％CI:0.091-0.371,P＜0.001)and the blood pressure control rate was higher(OR=5.669,95％CI:2.307-13.933,P＜0.001)in the nutrition management group compared with traditional treatment group.Conclusions Combined nutritional man-agement reduces the risk of rapid CKD progression,improves blood pressure control rates,and does not increase the risk of malnutrition in CKD patients with hypertension.It suggests that the combined nutritional management model has favorable clinical benefits.
chronic kidney diseaserenal function progressionhypertensionnutritional management
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