Actual dietary intake versus dietary recommendation among patients with chronic kidney disease!-an observational study




Phosphorous, Anorexia, Chronic kidney disease, Recommended dietary allowance


Background: As diet is an important component of chronic kidney disease management. It is important to understand the actual dietary intake of these patients and see if they are able to meet their respective recommended dietary allowance (RDA), failing which they are predisposed to malnutrition. Hence the study was carried out to assess the actual dietary intake of the subjects with chronic kidney disease to understand the gap between recommendation and actual intake. Aim of this study was to assess the dietary intake of patients with chronic kidney disease.

Methods: Patients with chronic kidney disease in stages 3 and 4 were recruited based on the inclusion criteria and the information on demographics, medical history, subjective data and seven-day dietary recall were obtained. The quantitative and qualitative estimation of the seven-day dietary intake was computed using “Dietcal” software.

Results: Anorexia was observed among 54% of the study participants. The mean calorie, protein and carbohydrate intake was 959.69±166.49 Kcals, 27.94±5.36 g and 160.5±26.7 g respectively while mean intake of sodium, potassium and phosphorous were 88.65±42.88 mg, 944.5±188.69 mg and 560.77±127.64 mg respectively.

Conclusions: The actual dietary intake was lesser than the recommended intake as influenced by anorexia, dysguesia, early satiety and dietary restrictions. Poor nutrient intake per se is the primary influential factor in the onset of malnutrition. Hence, it is important to adopt customized approach rather than generalized nutrient restrictions imposed upon these patients.


Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260-72.

Agarwal SK, Dash SC, Irshad M, Raju S, Singh R, Pandey RM. Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dial Transplant. 2005;20(8):1638-42.

El Nahas AM, Bello AK. Chronic kidney disease: the global challenge. lancet. 2005;365(9456):331-40.

Iorember FM. Malnutrition in chronic kidney disease. Front Pediat. 2018;6:161.

Zha Y, Qian Q. Protein nutrition and malnutrition in CKD and ESRD. Nutri. 2017;9(3):208.

Chung SH, Carrero JJ, Lindholm B. Causes of poor appetite in patients on peritoneal dialysis. J Ren Nutrit. 2011;21(1):12-5.

Chung S, Koh ES, Shin SJ, Park CW. Malnutrition in patients with chronic kidney disease. Open J Inter Med. 2012;2(02):89-99.

Moe SM, Zidehsarai MP, Chambers MA, Jackman LA, Radcliffe JS, Trevino LL, et al. Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. CJASN. 2011;6(2):257.

Longvah T, An̲antan̲ I, Bhaskarachary K, Venkaiah K, Longvah T. Indian food composition tables. Hyderabad: National Institute of Nutrition, Indian Council of Medical Research; 2017.

Gutiérrez Sánchez D, Leiva Santos JP, Macías López MJ, Cuesta-Vargas AI. Prevalence of symptoms in advanced chronic kidney disease. Nefrol. 2018;38(5):560-2.

Tedla FM, Brar A, Browne R, Brown C. Hypertension in chronic kidney disease: navigating the evidence. Inter J Hypert. 2011;2011.

Kazancioğlu R. Risk factors for chronic kidney disease: an update. Kid Inter Suppl. 2013;3(4):368-71.

Cheung WW, Mak RH. Ghrelin in chronic kidney disease. Inter J Pep. 2010;2010.

Guldris SC, Parra EG, Amenós AC. Gut microbiota in chronic kidney disease. Nefrología (English Edition). 2017;37(1):9-19.

Macedo E, Malhotra R, Bouchard J, Wynn SK, Mehta RL. Oliguria is an early predictor of higher mortality in critically ill patients. Kid Inter. 2011;80(7):760-7.

Vaara ST, Parviainen I, Pettilä V, Nisula S, Inkinen O, Uusaro A, et al. Association of oliguria with the development of acute kidney injury in the critically ill. Kid Inter. 2016;89(1):200-8.

Babitt JL, Lin HY. Mechanisms of anemia in CKD. JASN. 2012;23(10):1631.

Carrero JJ, Stenvinkel P, Cuppari L, Ikizler TA, Kalantar-Zadeh K, Kaysen G, et al. Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM). J Renal Nut. 2013;23(2):77-90.

Martinez I, Saracho R, Montenegro J, Llach F. The importance of dietary calcium and phosphorous in the secondary hyperparathyroidism of patients with early renal failure. Ame J Kid Dis. 1997;29(4):496-502.

Chutia H, Ruram AA, Bhattacharyya H, Boruah P, Nath C. Association of secondary hyperparathyroidism with hemoglobin level in patients with chronic kidney disease. J Labo Physi. 2013;5(01):51-4.

Shrestha N, Gautam S, Mishra SR, Virani SS, Dhungana RR. Burden of chronic kidney disease in the general population and high-risk groups in South Asia: A systematic review and meta-analysis. PLoS One. 2021;16(10):e0258494.

Wang Z, do Carmo JM, Aberdein N, Zhou X, Williams JM, Da Silva AA, et al. Synergistic interaction of hypertension and diabetes in promoting kidney injury and the role of endoplasmic reticulum stress. Hypert. 2017;69(5):879-91.

Carrero JJ, González-Ortiz A. Anorexia and appetite stimulants in chronic kidney disease. InNutritional Management of Renal Disease. 4th ed. Academic Press; 2022:893-906.

Fenton A, Montgomery E, Nightingale P, Peters AM, Sheerin N, Wroe AC, et al. Glomerular filtration rate: new age-and gender-specific reference ranges and thresholds for living kidney donation. BMC Nephrol. 2018;19(1):1-8.

Brancaccio D, Cozzolino M, Gallieni M. Hyperparathyroidism and anemia in uremic subjects: a combined therapeutic approach. J Ame Soci Nephrol. 2004;15(1_suppl):S21-4.

Kalantar‐Zadeh K, Tortorici AR, Chen JL, Kamgar M, Lau WL, Moradi H, et al. Dietary restrictions in dialysis patients: is there anything left to eat?. InSeminars Dial. 2015;28(2):159-68.

Shinaberger CS, Greenland S, Kopple JD, Van Wyck D, Mehrotra R, Kovesdy CP, et al. Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease? Ame J Clin Nutri. 2008;88(6):1511-8.

Tran L, Batech M, Rhee CM, Streja E, Kalantar-Zadeh K, Jacobsen SJ, et al. Serum phosphorus and association with anemia among a large diverse population with and without chronic kidney disease. Nephrol Dial Transplant. 2016;31(4):636-45.

Rajapurkar MM, John GT, Kirpalani AL, Abraham G, Agarwal SK, Almeida AF, et al. What do we know about chronic kidney disease in India: first report of the Indian CKD registry. BMC Nephrol. 2012;13:1-8.

Sundhir N, Joshi S, Adya CM, Sharma R, Garg H. Profile of anemia in chronic kidney disease patients at a rural tertiary care centre: a prospective observational study. Inter J Contemp Medi Res. 2018;5(5):E30-3.

Fraser SD, Roderick PJ, May CR, McIntyre N, McIntyre C, Fluck RJ, et al. The burden of comorbidity in people with chronic kidney disease stage 3: a cohort study. BMC Nephrol. 2015;16(1):1-1.

Mitch WE, Remuzzi G. Diets for patients with chronic kidney disease, still worth prescribing. J Ame Soci Nephrol. 2004;15(1):234-7.

Jadeja YP, Kher V. Protein energy wasting in chronic kidney disease: An update with focus on nutritional interventions to improve outcomes. Ind J Endocrinol Metabol. 2012;16(2):246.




How to Cite

S. S. Rao, A., A. J., H., & P., S. (2023). Actual dietary intake versus dietary recommendation among patients with chronic kidney disease!-an observational study. International Journal Of Community Medicine And Public Health, 10(9), 3164–3171.



Original Research Articles