Vegetarian diet in dialysis patients: A significant gap between actual intake and current nutritional recommendations
Medicine (Baltimore). 2021 Feb 12;100(6):e24617. doi: 10.1097/MD.0000000000024617.
Mei-Yin Chen 1 2, Shih-Hsiang Ou 3 4, Ming-Chen Yen 1, Meei-Shyuan Lee 5, Nai-Ching Chen 6, Chun-Hao Yin 4, Chien-Liang Chen 3 4 7
- Peritoneal dialysis probably consumes a lot more vitamin D than haemodialysis
- Peritoneal Dialysis nicely treated by active vitamin D – July 2013
- Dialysis patients who added Vitamin D were 41 percent less likely to get infection – Meta-analysis July 2018
- Kidney Dialysis clinics reluctant to add vitamin D treatment as they are not reimbursed – Oct 2012
- And – treating with vitamin D would decrease their number of patients thus and their income
Nutritional status is a predictor of mortality and morbidity in dialysis patients. This study aimed to assess dietary behaviors in dialysis patients compared to the recommendations of the Kidney Disease Outcomes Quality Initiative. Ninety five dialysis patients recruited from a hospital completed a 24-hour dietary recall questionnaire. Body weight, energy requirements, protein requirements, albumin, normalized protein catabolic rate, and 25(OH) vitamin D levels were measured.
Of the 95 patients, 11 (11.6%) were below the desirable body mass index range, 59 (62.1%) were within the desired range, and 25 (26.3%) were above the desired range.
- 32.7% of patients met the target energy intake,
- 29.5% reached the protein intake target, and
- 20.0% had adequate vitamin D concentrations.
Vegetarian patients had lower energy, protein, fat, vitamin D intake, lower body mass index, serum blood urea nitrogen, creatinine, phosphate, normalized protein catabolic rate, and vitamin D status than the omnivorous patients (P < .05).
After adjusting for age, sex, and body weight, vegetarianism was an independent risk factor for severe vitamin D deficiency (<10 ng/ml, P < .01). Most dialysis patients do not meet their dietary recommendations or goals. The risk of a vegetarian diet may outweigh the benefits in dialysis patients. Careful consideration of dietary behaviors is required for dialysis patients to prevent malnutrition, more so in vegetarians.