Effect of nurse-led food exchange intervention for patients undergoing peritoneal dialysis

Aim: We aimed to apply nurse-led food exchange model intervention to peritoneal dialysis (PD) patients and verify its effectiveness. Background: Protein-energy malnutrition is a prominent problem in patients on PD, and it has been estimated that 40% of PD patients suffer from malnutrition to some extent. Introduction: The rate of malnutrition among PD patients has been relatively high in recent years. Although a lot of effort has been made to alter the situation, an effective method has yet to be implemented. Materials and methods: We recruited 142 patients according to the inclusion and exclusion criteria and divided them into study group (n = 71) and control group (n = 71) using a random-number table generated by SPSS22.0. The control group received routine dietary guidance and instruction while the study group received nurse-led food exchange intervention. The subjective global assessment (SGA) scale scores, nutrition parameter, and dialysis efficacy indicators between the two groups were compared at baseline and after 12 months of intervention. Results: There were no significant differences between the two groups in all dimensions at the baseline measures (p > 0.05). However, after 12 months of intervention, the study group represented a higher score of SGA while the control group declined, which was significantly different (p = 0.022). The study group had an improved level of body mass index, triceps skinfold thickness, middle-arm muscle circumference, serum albumin, prealbumin, and normalized protein catabolic rate, while the control group showed decreased levels, and these results were significantly different (p = 0.001, p = 0.019, p = 0.001, p < 0.001, p = 0.043, respectively). Moreover, blood urea nitrogen declined in the study group and increased in the control group, which was significantly different (p = 0.004). Conclusion: Nurse-led food exchange model intervention improved nutrition condition of PD patients dramatically. Implications for nursing and/or health policy: Our study provides a basis for health policy designers to develop nutrition programs and encourage clinical nurses to participate in PD patients' diet management.