Protein Counting as an Educational Strategy to Optimize Low-Protein-Diet Adherence and Satisfaction in Stage 4 and 5 Chronic Kidney Disease Patients: A Pilot Study

Background/Objectives: Educational support is a well-established strategy in diet management for chronic diseases. No study has reported the impact of protein counting in a low-protein diet for chronic kidney disease (CKD). We aimed to assess how a protein-counting educational program could enhance adherence and satisfaction in managing a low-protein diet in CKD patients with an eGFR below 20 mL/min/1.73 m2. Methods: We conducted a prospective pilot study comparing adherence and satisfaction before and after an educational program, which included four group meetings and two individual meetings over six months. Diet adherence was assessed by estimating protein intake using 24 h urine urea excretion, while diet satisfaction was evaluated with the MDRD questionnaire. Results: Twenty-four patients with a mean age of 63.9 years experienced improved diet adherence, with a significant reduction in protein intake (from 59.82 ± 15.57 g/day to 47.18 ± 13.7 g/day, p < 0.001) and a significant inc...