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J Nephrol. 2018 Aug;31(4):457-473. doi: 10.1007/s40620-018-0497-z. Epub 2018 May 24.

Nutritional treatment of advanced CKD: twenty consensus statements.

Author information

1
Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Via Roma 67, 56126, Pisa, Italy. adamasco.cupisti@med.unipi.it.
2
SC Multizonale di Nefrologia e Dialisi, APSS, Trento, Italy.
3
UOC di Nefrologia, PO "A. Landolfi", Solofra, AV, Italy.
4
Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Via Roma 67, 56126, Pisa, Italy.
5
ANDID Associazione Nazionale Dietisti, Verona, Italy.
6
Dipartimento di Medicina, USL Umbria 1, Perugia, Italy.
7
Dipartimento dell'Emergenza e dei Trapianti di Organi D.E.T.O. - Sezione di Nefrologia, Dialisi e Trapianti, Università degli Studi di Bari Aldo Moro, Bari, Italy.
8
Divisione di Nefrologia, Dialisi e Trapianto Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona" Salerno, Salerno, Italy.
9
Nefrologia e Dialisi, ASL Cagliari Consultant, Cagliari, Italy.
10
SOS Nefrologia Pistoia, ASL Toscana Centro, Florence, Italy.
11
Nutrizione e Dietetica Aziendale, AUSL Modena, Modena, Italy.
12
UO Nefrologia, ASST Spedali Civili e Università di Brescia, Brescia, Italy.
13
Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Turin, Italy.
14
Centre Hospitalier Le Mans, Le Mans, France.
15
Nefrologia e Dialisi, Azienda Ospedaliera di Perugia, Perugia, Italy.
16
Nefrologia e Dialisi, ASL TO5, Chieri, TO, Italy.
17
Dipartimento di Medicina Clinica e Sperimentale-UOC di Nefrologia e Dialisi, Università di Messina, Messina, Italy.
18
ANED Onlus, Milan, Italy.
19
Unità di Fisiopatologia Insufficienza Renale, Università di Parma, Parma, Italy.
20
Dipartimento di Medicina, Università Cattolica del Sacro Cuore, Rome, Italy.
21
Università degli Studi di Genova, DIMI and IRCCS AOU San Martino IST, Genoa, Italy.
22
SC Nefrologia e Dialisi Arcispedale S. Maria Nuova Azienda USL Reggio Emilia, Reggio Emilia, Italy.
23
Nefrologia e Dialisi, Ospedale S. Maria Scaletta, Azienda USL Imola, Imola, Italy.
24
Divisione di Nefrologia, Università della Campania "Luigi Vanvitelli", Naples, Italy.
25
SC Nefrologia e Dialisi, Ospedale Manzoni, ASST, Lecco, Italy.

Abstract

The Italian nephrology has a long tradition and experience in the field of dietetic-nutritional therapy (DNT), which is an important component in the conservative management of the patient suffering from a chronic kidney disease, which precedes and integrates the pharmacological therapies. The objectives of DNT include the maintenance of an optimal nutritional status, the prevention and/or correction of signs, symptoms and complications of chronic renal failure and, possibly, the delay in starting of dialysis. The DNT includes modulation of protein intake, adequacy of caloric intake, control of sodium and potassium intake, and reduction of phosphorus intake. For all dietary-nutritional therapies, and in particular those aimed at the patient with chronic renal failure, the problem of patient adherence to the dietetic-nutritional scheme is a key element for the success and safety of the DNT and it can be favored by an interdisciplinary and multi-professional approach of information, education, dietary prescription and follow-up. This consensus document, which defines twenty essential points of the nutritional approach to patients with advanced chronic renal failure, has been written, discussed and shared by the Italian nephrologists together with representatives of dietitians (ANDID) and patients (ANED).

KEYWORDS:

CKD; Chronic renal failure; Dialysis; Diet; Kidney transplant; Nutritional treatment

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