Abstract
Due to the unique role of the kidney in the metabolism of nutrients, patients with chronic kidney disease (CKD) lose the ability to excrete solutes and maintain homeostasis. Nutrient intake modifications and monitoring of nutritional status in this population becomes critical, since it can affect important health outcomes, including progression to kidney failure, quality of life, morbidity, and mortality. Although there are multiple hemodynamic and metabolic factors involved in the progression and prognosis of CKD, nutritional interventions are a central component of the care of patients with non-dialysis CKD (ND-CKD) and of the prevention of overweight and possible protein energy-wasting. Here, we review the reno-protective effects of diet in adults with ND-CKD stages 3–5, including transplant patients.
Highlights
Advanced chronic kidney disease (CKD) is a systemic disorder which is associated with high mortality and poor quality of life
We aim to summarize recent studies on the role of diet, focusing on salt and protein restriction, as well as the use of supplements with essential amino acids (AAs) and keto analogs (KAs) to delay the progression of CKD and, at the same time, to preserve the nutritional status of patients with non-dialysis CKD (ND-CKD)
More protein is degraded than is synthesized, so more nitrogen is excreted than is ingested [38]. The latter is relevant for CKD patients under low protein diet (LPD), who may be at risk for developing proteinenergy wasting (PEW) if not adequately monitored
Summary
Due to the unique role of the kidney in the metabolism of nutrients, patients with chronic kidney disease (CKD) lose the ability to excrete solutes and maintain homeostasis. Nutrient intake modifications and monitoring of nutritional status in this population becomes critical, since it can affect important health outcomes, including progression to kidney failure, quality of life, morbidity, and mortality. There are multiple hemodynamic and metabolic factors involved in the progression and prognosis of CKD, nutritional interventions are a central component of the care of patients with non-dialysis CKD (ND-CKD) and of the prevention of overweight and possible protein energy-wasting. We review the reno-protective effects of diet in adults with ND-CKD stages 3–5, including transplant patients
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