title: Diet in chronic kidney disease in a Mediterranean African country.
abstract: Mediterranean diet is characterized by low to moderate consumption of animal protein and high consumption of fruits, vegetables, bread, beans, nuts, seeds and other cereals. It has been associated with reduced risk of cardiovascular disease. However, it is not suitable for chronic kidney disease because of high potassium intake.
  
  
  
  Tunisia is an emerging Mediterranean country with limited resources, a high prevalence of chronic hemodialysis treatment and high dialysis expenditures. In order to limit dialysis cost, primary and secondary prevention of chronic renal disease are of paramount importance. In addition to drugs, secondary prevention includes diet measures (e.g. salt diet, protein diet). The aims of diet practice in chronic kidney disease are to slow chronic renal failure progression and to prevent its complications like hyperphosphatemia and hyperkaliemiae. A few decades ago, a Tunisian diet was exclusively Mediterranean, and protein consumption was not excessive. However, today, protein consumption is more comparable to western countries. Salt consumption is also excessive. Some Tunisian diets still include food with high potassium intake, which are not suitable for patients with chronic kidney disease. Therefore, the role of the dietician is extremely important to help calculate and create a dietary regimen tailored to each of our patients. Advice about diets should be adapted to both the patient and population habits to improve adherence rate. As such, the purpose of this article is to provide our own experience regarding medical nutrition therapy in patients with chronic kidney disease in Tunisia, with some changes in food habits. Prevention is far better than treatment. In this perspective, dietary measures must be at the core of our intervention.
authors.affiliation: Neprology Department Hedi Chaker Hospital, Sfax, Tunisia. KhawlaKammoun2002@yahoo.fr.|Renal Pathology Unit, UR 12 ES 14 Medecin, University Sfax Tunisia, Sfax, Tunisia. KhawlaKammoun2002@yahoo.fr.
authors.forename: Khawla
authors.initials: K
authors.lastname: Kammoun
authors.affiliation: Neprology Department Hedi Chaker Hospital, Sfax, Tunisia.|Renal Pathology Unit, UR 12 ES 14 Medecin, University Sfax Tunisia, Sfax, Tunisia.
authors.forename: Hanen
authors.initials: H
authors.lastname: Chaker
authors.affiliation: Neprology Department Hedi Chaker Hospital, Sfax, Tunisia.|Renal Pathology Unit, UR 12 ES 14 Medecin, University Sfax Tunisia, Sfax, Tunisia.
authors.forename: Hichem
authors.initials: H
authors.lastname: Mahfoudh
authors.affiliation: Neprology Department Hedi Chaker Hospital, Sfax, Tunisia.
authors.forename: Nouha
authors.initials: N
authors.lastname: Makhlouf
authors.affiliation: Neprology Department Hedi Chaker Hospital, Sfax, Tunisia.|Renal Pathology Unit, UR 12 ES 14 Medecin, University Sfax Tunisia, Sfax, Tunisia.
authors.forename: Faical
authors.initials: F
authors.lastname: Jarraya
authors.affiliation: Neprology Department Hedi Chaker Hospital, Sfax, Tunisia.|Renal Pathology Unit, UR 12 ES 14 Medecin, University Sfax Tunisia, Sfax, Tunisia.
authors.forename: Jamil
authors.initials: J
authors.lastname: Hachicha
mesh_terms: D038441:Diet, Mediterranean / Q000009:adverse effects; D004044:Dietary Proteins; D006801:Humans; D006947:Hyperkalemia / Q000209:etiology / Q000517:prevention & control*; D054559:Hyperphosphatemia / Q000209:etiology / Q000517:prevention & control*; D019266:Iron, Dietary; D016226:Phosphorus, Dietary; D017419:Potassium, Dietary / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000178:diet therapy*; D055502:Secondary Prevention; D017673:Sodium Chloride, Dietary / Q000009:adverse effects; D014416:Tunisia; D014807:Vitamin D
chemical_list: D004044:Dietary Proteins; D019266:Iron, Dietary; D016226:Phosphorus, Dietary; D017419:Potassium, Dietary; D017673:Sodium Chloride, Dietary; D014807:Vitamin D
keywords: Chronic renal failure; Diet; Low protein diet; Phosphorus; Potassium; Sodium