Nutritional management in patients with chronic kidney disease

Abstract

The global prevalence of chronic kidney disease (CKD) is increasing with the aging of populations worldwide. As kidney function declines, the accumulation of metabolic waste products and excessive electrolytes can significantly impair the health of patients with CKD. As nutritional management of patients with CKD is thought to control uremic symptoms and provide beneficial effects on the progression of kidney dysfunction, the diet of patients with CKD should be an important consideration in their care. Many guidelines recommend limiting protein intake in these patients, as high-protein diets aggravate kidney dysfunction. Excess sodium may be associated with CKD progression and all-cause mortality and, therefore, limiting salt intake is generally recommended. Low potassium is associated with muscle weakness and hypertension, whereas high potassium is associated with cardiac arrhythmia. Therefore, recent guidelines recommend adjusting dietary potassium intake on an individual basis to maintain serum potassium levels within the normal range. Appropriate dietary calcium intake is recommended to maintain calcium balance in patients with CKD G3, G4. Given the many dietary considerations for patients with CKD, effective nutritional management is challenging. Individualized strategies are needed to ensure the best outcome for patients with CKD.

Association of Blood Heavy Metal Levels and Renal Function in Korean Adults

“…CKD is a disease in which the kidneys are damaged for more than three months, or their function continues to decrease. It is often difficult to detect CKD early because patients do not have any symptoms in the early stages [ 39 ]. In this study, the proportion of people diagnosed with hypertension and diabetes was 10.98% and 6.07% respectively if GFR was 90 or higher, but if GFR was less than 60, the proportion of people diagnosed with hypertension and diabetes was 72.15% and 34.18%, respectively, indicating that preventive measures for kidney failure are needed indirectly.…”

Nutrition and quality of life in chronic kidney disease patients: a practical approach for salt restriction

“…Too strict salt restriction may decrease quality of life, aggravate CKD, and eventually induce PEW. Sharing knowledge and experience may facilitate observational studies and RCTs to further improve the care of CKD patients [98,99].…”

Clinical and genetic characteristics of Korean autosomal dominant polycystic kidney disease patients

“…As with other CKD patients, individualized strategies are recommended according to each patient’s nutritional status, clinical comorbidities, and disease severity to prevent malnutrition, attenuate the progression of CKD, and decrease mortality [ 70 ].…”