title: Dietary Modeling of Foods for Advanced CKD Based on General Healthy Eating Guidelines: What Should Be on the Plate?
abstract: Chronic kidney disease (CKD) is a major public health problem with significant clinical, societal, and psychosocial burdens. Nutrition therapy has been an integral part of the medical management of patients with CKD for more than a century, with the main goals of preserving kidney function and preventing complications. Nutrition abnormalities may emerge well before dialysis therapy is initiated and are associated with poor outcomes. It is therefore important to revisit nutrition management in the advanced stages of CKD to gain a broader insight into its role and effect on patient outcomes. Traditionally, nutrition recommendations have focused on the prescription of energy (calories) and macro- and micronutrients. Today, dietary modeling also focuses on the evidence for food consumption on health. This review argues that advanced non-dialysis-dependent CKD nutrition requirements to a large extent align with healthy eating guidelines for the general population and should not be based on deprivation or be unusually restrictive. The best currently available evidence for the CKD diet is likely to be derived from CKD nutrition prescriptions in conjunction with evidence underpinning national dietary guidelines and evidence of healthy dietary patterns, such as Mediterranean-style and Dietary Approaches to Stop Hypertension (DASH)-style eating. Positive messages from these dietary patterns should improve acceptance of CKD dietary interventions among patients.
authors.affiliation: Department of Nutrition and Dietetics, The St. George Hospital, Kogarah, NSW, Australia; Department of Nutrition and Dietetics, School of Medicine, University of Wollongong, Wollongong, NSW, Australia; Department of Renal Medicine, The St. George Hospital, Kogarah, NSW, Australia; St. George Clinical School, School of Medicine, The University of New South Wales, NSW, Australia. Electronic address: maria.chan@health.nsw.gov.au.
authors.forename: Maria
authors.initials: M
authors.lastname: Chan
authors.affiliation: Department of Renal Medicine, The St. George Hospital, Kogarah, NSW, Australia; St. George Clinical School, School of Medicine, The University of New South Wales, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Kelly
authors.affiliation: Department of Nutrition and Dietetics, School of Medicine, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Tapsell
mesh_terms: D003611:Dairy Products; D002523:Edible Grain; D005638:Fruit; D006801:Humans; D008460:Meat; D018673:Nutrition Policy; D051436:Renal Insufficiency, Chronic / Q000178:diet therapy*; D014675:Vegetables
keywords: Nutrition; chronic kidney disease (CKD); foods