Nutritional recommendations in CKD
It is recommended to reduce protein intake in non-dialysis patients to 0.6-0.8 g/kg body weight, where protein should mainly be of high biological value (animal protein and/or legumes).
Besides this classical low-protein diet, a very-low protein diet (0.3 g protein/kg body weight), supplemented with essential amino acids is a safe and effective treatment for motivated and well monitored patients to postpone the need for RRT as long as possible.
To prevent protein-energy wasting (PEW) monitoring by the nephrologist and a trained dietitian is fundamental to ensure the patient is receiving sufficient energy in their diet.
Phosphorus and sodium restrictions are essential for a good dietary management. In case of hyperpotassemia also dietary potassium needs to be watched.
The updated KDOQI guidelines for CKD care are supposed to be published in 2019.
Brunori G et al. Efficacy and safety of a very-low-protein diet when postponing dialysis in the elderly: a prospective randomized multicenter controlled study. Am J Kidney Dis., 2007; 49(5):569-80.
Davidson SN, Levi A, Moss AH et al. Executive summary of the KDIGO controversies conference on supportive care in chronic kidney disease: developing a roadmap to improving quality care. Kidney Int, 2015; 88:447-449.