Nutrition and chronic kidney disease
Open accessAbstract
The incidence of malnutrition disorders in chronic kidney disease (CKD) appears unchanged over time, whereas patient-care and dialysis techniques continue to progress. Despite some evidence for cost-effective treatments, there are numerous caveats to applying these research findings on a daily care basis. There is a sustained generation of data confirming metabolic improvement when patients control their protein intake, even at early stages of CKD. A recent protein-energy wasting nomenclature allows a simpler approach to the diagnosis and causes of malnutrition. During maintenance dialysis, optimal protein and energy intakes have been recently challenged, and there is no longer an indication to control hyperphosphatemia through diet restriction. Recent measurements of energy expenditure in dialysis patients confirm very low physical activity, which affects energy requirements. Finally, inflammation, a common state during CKD, acts on both nutrient intake and catabolism, but is not a contraindication to a nutritional intervention, as patients do respond and improve their survival as well as do noninflamed patients.
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In patients with nondiabetic CKD stages 3 and 4 (moderate to severe) up to age 70, there is evidence that low-protein diets can slow the progression of CKD.
“In patients with nondiabetic CKD stages 3 and 4 (moderate to severe) up to age 70, there is evidence that low-protein diets can slow the progression of CKD.112e114”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [113]
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- Authors
- Fouque, D., Pelletier, S., Mafra, D., & Chauveau, P.
- Affiliations
- Inserm (FR)
- Universidade Federal Fluminense (BR)
- Corresponding author
- Mafra, Denise
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 80
- Issue
- 4
- Pages
- 348-357
- ISSN
- 0085-2538 (ISSN-L)
- OpenAlex
- W2045411633
- Cited by
- 190
- References
- 120
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 11 · 2023: 8 · 2022: 12 · 2021: 18 · 2020: 16 · 2019: 16 · 2018: 10 · 2017: 17 · 2016: 12 · 2015: 16 · 2014: 17 · 2013: 19 · 2012: 14
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Kidney International (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- chronic kidney disease, malnutrition, protein-energy wasting, protein intake, energy requirements, dialysis, hyperphosphatemia, energy expenditure, physical activity, inflammation, dietary intervention, survival
- MeSH terms
- Animals, Chronic Disease, Dietary Proteins, Energy Metabolism, Renal Dialysis, Humans, Inflammation, Kidney Diseases, Nutritional Status, Protein-Energy Malnutrition, Risk Factors, Treatment Outcome, Risk Assessment, Malnutrition
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