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Kidney Week

Abstract: FR-PO1063

A Journey through Low-Energy Diets in Adults with Kidney Disease: Insights from the Slow-CKD Feasibility Study

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Conley, Marguerite M., Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Scholes-Robertson, Nicole Jane, School of Public Health, the University of Sydney, Sydney, New South Wales, Australia
  • Cunningham, Soraya Lynne, Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Hepburn, Kirsten S., Kidney Health Service Metro North Hospital and Health Service, Brisbane, Queensland, Australia
  • Mayr, Hannah L., Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Mudge, David William, Department of Kidney and Transplant Services, Brisbane, Queensland, Australia
  • Holland, Justin James, Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia
  • Johnson, David W., Department of Kidney and Transplant Services, Brisbane, Queensland, Australia
  • Viecelli, Andrea K., Department of Kidney and Transplant Services, Brisbane, Queensland, Australia
  • MacLaughlin, Helen L., Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia
Background

Low energy diets (LEDs) (800-1000 kcal/day) are a proven approach in diabetes management to achieve 10 to 15kg weight loss and diabetes remission. LEDs are an emerging strategy for obesity management in CKD. Understanding consumer experiences of LED programs is critical to help explore feasibility, acceptability and future development and translation. The aim of this study is to describe participants’ experiences of, and satisfaction with being involved in a LED weight loss randomized controlled trial (RCT).

Methods

Participants living with stages 1-3 CKD and BMI >30kg/m2 from the SLOW-CKD feasibility RCT participated in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analysis. The questions explored participants' experiences and perceptions of following a 3-month LED followed by a 3-month weight maintenance program, or receiving usual care (UC) weight loss support, and participating in a RCT.

Results

Twenty-five adults (14 intervention, 11 UC) were interviewed. Six themes emerged reflecting the lifelong mental and physical struggle of living with obesity; varied motivation to join the study; the importance of health professional and peer support, flexible study appointments and LED approach; and benefits beyond weight loss. After overcoming initial challenges, intervention participants adapted to the LED and were pleased with their commitment and success, many noting improvements in eating habits, diet quality, physical function, and sleep. Several UC participants expressed disappointment and a sense of missed opportunity.

Conclusion

Our findings recognize the uphill battle faced by adults living with CKD and excess weight. Various internal and external factors influenced their decision to start and continue their weight loss journey. LED programs are acceptable if individualised and backed by trusted healthcare professionals. Our findings support LED use in clinical practice and further research on effectiveness on slowing CKD progression. Future trials should include innovative ways to strike balance between scientific rigour and minimising randomisation disappointment.

Funding

  • Private Foundation Support