Nutrition and Chronic Kidney Disease

Denis Fouque; Solenne Pelletier; Denise Mafra; Philippe Chauveau

Disclosures

Kidney Int. 2011;80(4):348-357. 

In This Article

Conclusion

Fifty years after the first dialysis treatments, nutrition is still a recurrent issue and many disorders are currently not well understood. However, there has been progress in nutritional targets in CKD patients before and during maintenance treatment. Before dialysis, there is good evidence that a long-standing nutritional care plan, with a control of protein intake, is efficient in correcting many metabolic disorders, including proteinuria, and is cost-effective. During dialysis, nutritional targets have gained in understanding and phosphate metabolism does not appear a sufficient issue to reduce protein intake, as compared with the risk of superimposed mortality when patients' intakes are reduced. New devices recording physical activity report dramatically reduced energy expenditure in dialysis patients and call for sustained physical activity plans as a part of routine treatment. New classification of nutritional disorders in CKD patients may help physicians to more easily identify initial protein–energy wasting. Finally, inflammation, a common CKD disorder, is responsible for anorexia and catabolism, but inflamed patients can respond to supplemental nutrition as well as noninflamed ones.

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