Evidence based practice guidelines for the nutritional management of chronic kidney disease

Abstract

The purpose of these guidelines is to provide dietitians in Australia and New Zealand with a summary of evidence based clinical guidelines related to the dietetic management of adult patients with chronic kidney disease. The patient target group is any adult patient fulfilling the definition and diagnostic criteria of Chronic Kidney Disease (CKD), excluding those with nephrotic syndrome. These guidelines by definition also exclude acute renal failure and transplantation. The clinical questions were as follows: • At what level of glomerular filtration rate (GFR) should patients be referred to the dietitian in order to maximise nutritional intervention opportunities? • Which specific measures best reflect nutritional status or change in nutritional status in CKD? • What are the goals of nutrition intervention for CKD? • What is (are) the appropriate nutritional intervention(s) to optimise nutritional status in CKD and prevent malnutrition? • What is the optimal method of implementation and follow up to ensure nutritional status is maintained or improved? These guidelines are meant to serve as a general framework for handling patients with particular health problems. It may not always be appropriate to use these guidelines to manage clients because individual circumstances may vary. The independent skill and judgement of the health care provider must always dictate treatment decisions. These guidelines for practice are provided with the express understanding that they do not establish or specify particular standards of care, whether legal, medical or other. 1