Consumo alimentar de indivíduos com doença renal crônica: estudo populacional com dados da Pesquisa Nacional de Saúde

Abstract

According to recent published studies, an adequate and healthy diet is associated with a delay in the progression of chronic kidney disease (CKD), with a postpone in the initiation of renal replacement therapy, with an improvement the complications of the disease and with better survival. Thus, the assessment of food consumption is relevant for the dietary treatment of CKD. The analysis of dietary patterns, which values the overall diet by considering the simultaneous effect of multiple foods and dietetic components, as well as their interactions, has been proposed as new approach to evaluate food consumption. However, few studies have evaluated the dietary pattern of individuals with CKD. Therefore, the present study aims to evaluate the food consumption of individuals that self-declared themselves with CKD, using data from the National Health Survey (Brazilian NHS) 2013. The aim of the first paper was to describe the food consumption of individuals with CKD per sociodemographic and geographic characteristics and CKD treatment. In addition, the food consumption of individuals with and without CKD was compared. The main findings of the first article showed that age, educational level and geographic regions were associated with food consumption markers. In addition, comparisons between the CKD treatment groups (non-dialysis dependent group n=480, dialysis group n=48, renal transplanted group n=17, untreated group n=294) showed that the dialysis group had a lower regular consumption of beans, alcoholic beverages and salt in excess. When furthering the comparisons with the non-CKD group (n = 59,363), the CKD group (especially the dialysis group) had a lower regular consumption of beans, red meat, sugar-sweetened beverages, salt in excess and alcoholic beverage. Except for sugar-sweetened beverages, this difference was maintained after adjustments for sociodemographic and geographical variables. Subsequently, we sought to investigate the role of treatment CKD on food consumption. Therefore, the aims of the second study were to describe the dietary patterns of Brazilian individuals with CKD and to analyse the influence of CKD treatment on these patterns. The main findings were the identification of three food patterns: Unhealthy pattern (red meat, sweet sugar beverages, alcoholic beverage, sweets and beans and a negative loading of fresh juice fruit, excessive salt and fish), Healthy pattern (raw and cooked vegetables, fruits, fresh juice fruit and milk) and Snack pattern (replacing one meal for a snack, sweets, sweet sugar beverages and a negative loading for beans). Regarding the influence of the CKD treatment, the unhealthy pattern was inversely associated with non-dialysis dependent, dialysis and renal transplanted groups. Moreover, the healthy pattern was positively associated with the renal transplant group. In conclusion, the results of both studies suggest that socio-demographic and geographic factors were associated with food consumption markers and that the consumption of some food markers of CKD patients differed from those observed for healthy individuals. In addition, in the group of patients with CKD, 3 dietary patterns were identified, and the type of treatment was associated with the dietary pattern. These studies indicates the importance of evaluating the food consumption of this population, which provide important information for the treatment of Brazilian individuals with CKD