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This study will test the effectiveness of remotely delivered medical nutrition therapy (MNT), focused on increasing fruit/vegetable intake, and decreasing sodium and red/processed meat intake, in the treatment of patients with stage 1-2 chronic kidney disease (CKD) and diabetes.
Participants with diabetes and early CKD (stage 1-2) will be invited to participate in a prospective matched cohort study design to evaluate the effectiveness of an intensive remote dietary counseling program on kidney health. A total of 40 diabetic patients with early CKD and Geisinger Health Plan (GHP) insurance will be recruited for the intensive dietary modification, which will consist of having the patients complete a weekly telephone visit with the dietician as well as enter dietary information on the MyFitnessPal mobile app or website for a total of 8 weeks. To increase generalizability of this study, the investigators will recruit 20 patients with smartphone/internet access and 20 patients who have internet but no smartphone access. During the following year, patients will receive a bi-annual phone call to review participants progress. The need for further intensive weekly counseling will be assessed by the dietician and provided if indicated. Each intervention patient will be matched by demographics and comorbidities to 5 control patients with diabetes, early CKD and GHP insurance, who have previously been seen by a nutritionist at Geisinger. Control patients will receive no specific intervention.
Aim 1 - The investigators will examine whether remotely delivered MNT can improve dietary quality over a 12-month period.
Aim 2 - The investigators will compare rates of eGFR (estimated glomerular filtration rate) decline in study participants over a 3-year period, compared to a matched cohort who receive standard care.
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
Chronic Kidney Disease
Not yet recruiting
Published on BioPortfolio: 2017-01-11T03:38:21-0500
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Conditions in which the KIDNEYS perform below the normal level for more than three months. Chronic kidney insufficiency is classified by five stages according to the decline in GLOMERULAR FILTRATION RATE and the degree of kidney damage (as measured by the level of PROTEINURIA). The most severe form is the end-stage renal disease (CHRONIC KIDNEY FAILURE). (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002)
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Decalcification of bone or abnormal bone development due to chronic KIDNEY DISEASES, in which 1,25-DIHYDROXYVITAMIN D3 synthesis by the kidneys is impaired, leading to reduced negative feedback on PARATHYROID HORMONE. The resulting SECONDARY HYPERPARATHYROIDISM eventually leads to bone disorders.
Abnormal enlargement or swelling of a KIDNEY due to dilation of the KIDNEY CALICES and the KIDNEY PELVIS. It is often associated with obstruction of the URETER or chronic kidney diseases that prevents normal drainage of urine into the URINARY BLADDER.
A severe irreversible decline in the ability of kidneys to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal failure, either acute (KIDNEY FAILURE, ACUTE) or chronic (KIDNEY FAILURE, CHRONIC), requires HEMODIALYSIS.
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