Affiliations 

  • 1 Division of Nephrology, Hypertension and Kidney Transplantation, University of California, Orange County, California
  • 2 Nephrology and Dialysis Division, Department of Medical Sciences, Hospital Sant'Anna e San Sebastiano, Caserta, Italy
  • 3 Service de Néphrologie, Department of Medicine, Centre Hospitalier Le Mans, Le Mans, France
  • 4 Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
  • 5 Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 6 Royal National Orthopaedic Hospital, London, UK
  • 7 Fresenius Kabi Nutritional Care Center, Mexico City, Mexico
  • 8 Department of Dietetics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 9 Department of Nephrology, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Cardiometabolism and Nutrition (CarMeN), Lyon, France. Electronic address: denis.fouque@univ-lyon1.fr
J Ren Nutr, 2023 Jul;33(4):508-519.
PMID: 36796502 DOI: 10.1053/j.jrn.2023.02.002

Abstract

An expert advisory board discussed the prevention and treatment of chronic kidney disease (CKD), with a focus on dietary options. This is timely, given the uptake of value based models for kidney care in the United States. Timing of dialysis start is influenced by patients' clinical status and complex patient-clinician interactions. Patients value personal freedom and quality of life and may want to delay dialysis, whilst physicians are sometimes more concerned with clinical outcomes. Kidney-preserving therapy can prolong the dialysis-free period and preserve residual kidney function, thus patients are asked to adjust their lifestyle and diet, to follow a low- or very low-protein diet, with or without ketoacid analogues. Multi-modal approaches include pharmacotherapies, management of symptoms, and a gradual, individualized dialysis transition. Patient empowerment is vital, including CKD education and involvement in decision making. These ideas may help patients, their families, and clinical teams to improve the management of CKD.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.