Browsing by Author "Esau, Nazeema"

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    Adaptation of the RenalSmart web-based application for the dietary management of patients with diabetic nephropathy
    (Medpharm Publications, 2013) Esau, Nazeema; Koen, Nelene; Herselman, Marietjie G.
    ENGLISH SUMMARY : Objectives: The aim of this study was to develop and test a web-based application for the dietary management of patients with diabetic nephropathy. Design: Observational descriptive study. Settings and subjects: RenalSmart® is a web-based application used to assist dietitians in clinical practice, from tertiary to primary care, to manage patients with chronic renal failure. The application was adapted and enhanced to include functions for the nutritional assessment of a patient with diabetic nephropathy, the formulation of a dietary prescription and the development of a meal plan and sample menu. It includes a graphical display of anthropometric and biochemical measurements. Quality assurance testing was undertaken throughout the development process by the project team in a pilot study involving generalist dietitians and dietitians who specialise in diabetic and renal nutrition. Nonrandom purposive sampling, including snowball sampling, was used to recruit them. Outcome measures: The application was finally tested for accuracy and acceptability by registered dietitians in South Africa. Results: Thirty-seven dietitians completed the final testing of the application. The mean age of the respondents was 33 years. Thirty-five per cent resided in the Western Cape. The overall acceptability of the application was rated as good to excellent by 81% of respondents. There was a significant difference between dietitians who usually consulted renal patients, compared to those who did not, in their rating of the accuracy of the data-saving function (p-value = 0.02) and the fluid requirements (p-value = 0.03). In this regard, the former group of dietitians was dissatisfied with these functions. Conclusion: The web-based application developed in this study was rated as accurate and acceptable by the majority of respondents. Identified problem areas were addressed in the final version.
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    Nutritional management of the vegan with end-stage kidney disease
    (MedPharm Publications, 2018) Esau, Nazeema; Ebrahim, Zarina
    Chronic kidney disease (CKD) is associated with nutritional complications such as anaemia, electrolyte imbalances, bone-mineral disorders, malnutrition and cardiovascular disease.1 The nutritional management in CKD is very complex since it includes multiple dietary factors e.g. the intake of protein, energy, sodium, phosphorus and potassium. Protein energy malnutrition is widely prevalent in this population, however recently obesity has also become more common. Poor dietary compliance often occurs in patients prescribed renal diets because it is known to be unpalatable and very restrictive with major lifestyle changes required.2,3 In a patient following a vegan diet, the complexity of dietary management increases due to further limitations in meeting specifically protein and micronutrient requirements. This is due to vegan diets being high in wholegrains, legumes, fruits and vegetables, which often need to be restricted in CKD.4 There are also some micronutrients that might be lacking due to avoidance of all animal products. Recent dietary pattern studies have indicated that healthy diet patterns in CKD patients reduced all-cause mortality with evidence from other studies also indicating that some of the dietary restrictions are not warranted.5,6,7 Chauveau et al8 suggested that plant-based diets should be used in clinical recommendations in the treatment and prevention of CKD. This case study explores a strictly vegan patient, admitted with end-stage kidney disease (ESKD) and his nutritional management which aimed at allowing the patient to continue veganism while trying to optimise his nutritional status.