TY - JOUR
T1 - Nutritional and Dietary Management of Chronic Kidney Disease Under Conservative and Preservative Kidney Care Without Dialysis
AU - Rhee, Connie M.
AU - Wang, Angela Yee Moon
AU - Biruete, Annabel
AU - Kistler, Brandon
AU - Kovesdy, Csaba P.
AU - Zarantonello, Diana
AU - Ko, Gang Jee
AU - Piccoli, Giorgina Barbara
AU - Garibotto, Giacomo
AU - Brunori, Giuliano
AU - Sumida, Keiichi
AU - Lambert, Kelly
AU - Moore, Linda W.
AU - Han, Seung Hyeok
AU - Narasaki, Yoko
AU - Kalantar-Zadeh, Kamyar
N1 - Funding Information:
Support: The authors are supported by the research grants from the NIH/NIDDK including R01-DK122767 (C.M.R.), R01-DK124138 (C.M.R., K.K.Z.), R01-DK132869 (C.M.R., K.K.Z.), and R01-DK132875 (K.K.Z., C.M.R.). A.B. was supported by Indiana CTSI-KL2 (This publication was made possible with support from Grant Numbers, KL2TR002530 (Sheri Robb, PI), and UL1TR002529 (Sarah Wiehe and Sharon Moe, co-PIs) from the National Institutes of Health , National Center for Advancing Translational Sciences , Clinical and Translational Sciences Award.) Funders of this study did not have any role in the study design; collection, analysis, and interpretation of data; writing of the report; nor the decision to submit the report for publication.
Publisher Copyright:
© 2023 The Authors
PY - 2023/11
Y1 - 2023/11
N2 - While dialysis has been the prevailing treatment paradigm for patients with advanced chronic kidney disease (CKD), emphasis on conservative and preservative management in which dietary interventions are a major cornerstone have emerged. Based on high-quality evidence, international guidelines support the utilization of low-protein diets as an intervention to reduce CKD progression and mortality risk, although the precise thresholds (if any) for dietary protein intake vary across recommendations. There is also increasing evidence demonstrating that plant-dominant low-protein diets reduce the risk of developing incident CKD, CKD progression, and its related complications including cardiometabolic disease, metabolic acidosis, mineral and bone disorders, and uremic toxin generation. In this review, we discuss the premise for conservative and preservative dietary interventions, specific dietary approaches used in conservative and preservative care, potential benefits of a plant-dominant low-protein diet, and practical implementation of these nutritional strategies without dialysis.
AB - While dialysis has been the prevailing treatment paradigm for patients with advanced chronic kidney disease (CKD), emphasis on conservative and preservative management in which dietary interventions are a major cornerstone have emerged. Based on high-quality evidence, international guidelines support the utilization of low-protein diets as an intervention to reduce CKD progression and mortality risk, although the precise thresholds (if any) for dietary protein intake vary across recommendations. There is also increasing evidence demonstrating that plant-dominant low-protein diets reduce the risk of developing incident CKD, CKD progression, and its related complications including cardiometabolic disease, metabolic acidosis, mineral and bone disorders, and uremic toxin generation. In this review, we discuss the premise for conservative and preservative dietary interventions, specific dietary approaches used in conservative and preservative care, potential benefits of a plant-dominant low-protein diet, and practical implementation of these nutritional strategies without dialysis.
KW - chronic kidney disease
KW - conservative management
KW - Nutrition
KW - plant-based diets
KW - preservative management
KW - Diet, Protein-Restricted
KW - Dietary Proteins
KW - Humans
KW - Renal Insufficiency, Chronic/complications
KW - Disease Progression
KW - Renal Dialysis
KW - Kidney/metabolism
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U2 - 10.1053/j.jrn.2023.06.010
DO - 10.1053/j.jrn.2023.06.010
M3 - Review article
C2 - 37394104
AN - SCOPUS:85168390204
SN - 1051-2276
VL - 33
SP - S56-S66
JO - Journal of Renal Nutrition
JF - Journal of Renal Nutrition
IS - 6S
ER -