Nutritional therapy in chronic kidney disease

Abstract

Dietary-Nutritional Therapy (DNT) is an essential component of the conservative management of patients with chronic kidney disease (CKD) as it helps to maintain the optimal nutritional status and to prevent and/or correct symptoms and complications of CKD. Moreover, it allows adherent patients to delay the onset of dialysis, leading to an improved quality of life and cost savings for both patients and the community. Through a survey, we aimed to evaluate how personalized diets were assessed, administered, and experienced by CKD patients. A questionnaire was administered to 180 patients from 4 Nephrology Centers in Lombardy (Italy) regarding their CKD and nutritional therapy. It showed that 73% of patients received dietary prescriptions. In 40% of cases, dietary prescriptions were administered in dedicated clinics and were valued as much as pharmacological ones. Most diets prescribed were low-protein diets (0.8 g protein per kg of body weight), although some included very low protein diets supplemented with keto analogues. Unfortunately, after the initial prescription, the monitoring of the adherence to nutritional therapy is not particularly frequent. In conclusion, our survey suggests that while patients in different Nephrology Centers receive proper dietary prescriptions and follow-ups, there is space for improvement with positive implications for CKD progression, delaying dialysis therapy.