The International Society of Renal Nutrition and Metabolism Commentary on the National Kidney Foundation and Academy of Nutrition and Dietetics KDOQI Clinical Practice Guideline for Nutrition in Chronic Kidney Disease

Brandon M. Kistler, Linda W. Moore, Debbie Benner, Annabel Biruete, Mona Boaz, Giuliano Brunori, Jing Chen, Christiane Drechsler, Fitsum Guebre-Egziabher, Mary Kay Hensley, Kunitoshi Iseki, Csaba P. Kovesdy, Martin K. Kuhlmann, Anita Saxena, Pieter ter Wee, Amanda Brown-Tortorici, Giacomo Garibotto, S. Russ Price, Angela Yee-Moon Wang, Kamyar Kalantar-Zadeh*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

The Academy of Nutrition and Dietetics and the National Kidney Foundation collaborated to provide an update to the Clinical Practice Guidelines (CPG) for nutrition in chronic kidney disease (CKD). These guidelines provide a valuable update to many aspects of the nutrition care process. They include changes in the recommendations for nutrition screening and assessment, macronutrients, and targets for electrolytes and minerals. The International Society of Renal Nutrition and Metabolism assembled a special review panel of experts and evaluated these recommendations prior to public review. As one of the highlights of the CPG, the recommended dietary protein intake range for patients with diabetic kidney disease is 0.6-0.8 g/kg/day, whereas for CKD patients without diabetes it is 0.55-0.6 g/kg/day. The International Society of Renal Nutrition and Metabolism endorses the CPG with the suggestion that clinicians may consider a more streamlined target of 0.6-0.8 g/kg/day, regardless of CKD etiology, while striving to achieve intakes closer to 0.6 g/kg/day. For implementation of these guidelines, it will be important that all stakeholders work to detect kidney disease early to ensure effective primary and secondary prevention. Once identified, patients should be referred to registered dietitians or the region-specific equivalent, for individualized medical nutrition therapy to slow the progression of CKD. As we turn our attention to the new CPG, we as the renal nutrition community should come together to strengthen the evidence base by standardizing outcomes, increasing collaboration, and funding well-designed observational studies and randomized controlled trials with nutritional and dietary interventions in patients with CKD.

Original languageEnglish
JournalJournal of Renal Nutrition
DOIs
Publication statusAccepted/In press - 1 Jan 2020

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