Perceptions of food and nutrition security among adults with CKD, non-dialysis: A mixed method study.

Abstract

Background: Food and nutrition insecurity may contribute to the progression of chronic kidney disease (CKD). Current metrics to measure food and nutrition security status may not capture the nuances associated with these concepts. The purpose of this mixed method study was to examine perceptions of food and nutrition security of adults with chronic kidney disease, non-dialysis.

Methods: A sequential explanatory mixed-method study was conducted from March - August 2024. Participants (n=60) completed a survey that focused on the dimensions of food and nutrition security and diet quality. A sub-section of participants (n=23) completed an interview that explored food and nutrition security. Frequencies and descriptives were analyzed using SPSS v28. Interviews were transcribed, and deductive and inductive coding was used to determine themes using NVIVO v14.

Results: Many participants (77%) were in stage 3 of CKD based on self-reported eGFR, were considered Black (47.5%) or Hispanic/Latino (45.9%), did not receive any food/government assistance (55.7%), and self-reported annual household income of $50,000 or more (70.5%). The median diet quality score was 35.5 out of 60. The themes from the interviews focused on specific aspects of food security dimensions, such as availability and accessibility, with other themes present, such as affordability, health, and support.

Conclusion: Affordability of food, health, and support were of concern for adults with CKD, regardless of income level. Traditional food security instruments need to expand to include more in-depth questions about the food and nutrition dimensions in alleviating any potential burdens that adults with CKD face in obtaining and consuming foods.