P746 - ASSOCIATION BETWEEN MEDITERRANEAN DIET ADHERENCE AND PATIENT-REPORTED OUTCOMES IN ADVANCED CHRONIC KIDNEY DISEASE: A SECONDARY ANALYSIS OF THE ERCANUT TRIAL

P746

ASSOCIATION BETWEEN MEDITERRANEAN DIET ADHERENCE AND PATIENT-REPORTED OUTCOMES IN ADVANCED CHRONIC KIDNEY DISEASE: A SECONDARY ANALYSIS OF THE ERCANUT TRIAL

M. Padial^1,2,3,*, A. Rebollo⁴, T. Jiménez-Salcedo⁴, G. Olveira^1,2,3

¹Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, ²Investigación Biomédica de Málaga–Plataforma BIONAND, ³Universidad de Málaga, Departamento de Medicina y Dermatología, ⁴Servicio de Nefrología , Hospital Regional Universitario de Málaga, Málaga, Spain

Rationale: Adherence to dietary recommendations is critical in patients with advanced chronic kidney disease (ACKD), yet its association with psychological well-being, self-management, and quality of life (QoL) is not well established. We aimed to assess whether greater adherence to the Mediterranean diet (MedDiet) correlates with improvements in these outcomes.

Methods: We conducted a secondary analysis of a pilot randomized controlled trial in patients with ACKD (stages 4–5, non-dialysis), randomized to either a nutrition education program (NEP) or a control group. Linear regression models were used to examine whether changes in MedDiet adherence—measured as the difference in PREDIMED score from baseline to 3 months—were associated with changes in anxiety and depression symptoms (HADS), CKD knowledge (KiKS), chronic disease self-management (SEMCD), and QoL domains (KDQoL-36). The change in PREDIMED score was included as a covariate, and analyses were conducted separately for the NEP and control groups.

Results: In the NEP group, greater increases in PREDIMED score were significantly associated with improvements in:

CKD knowledge (β=0.7; 95% CI [0.0, 0.2]; p=0.02)

Chronic disease self-management (β=1.2; 95% CI [1.3, 2.8]; p<0.001)

QoL domains: "effects of kidney disease" (β=0.6; 95% CI [2.3, 22.8]; p=0.02) and "disease burden" (β=0.6; 95% CI [3.0, 29.8]; p=0.02)

There was also a non-significant trend toward reduced anxiety (β=-0.5; p=0.08) and depression (β=-0.4; p=0.08). No significant associations were observed in the control group.

Conclusion: In patients receiving a NEP, increased adherence to the MedDiet was associated with improvements in CKD knowledge, self-efficacy, and selected QoL domains. These findings support the integration of dietary strategies into multidisciplinary care for ACKD to enhance patient-reported outcomes.

Disclosure of Interest: None declared