Caring for patients with advanced chronic kidney disease: Dietary options and conservative care instead of maintenance dialysis

Document Type

Article

Publication Date

7-1-2023

Abstract

An expert advisory board discussed the prevention and treatment of chronic kidney disease (CKD), with a focus on dietary options. This is timely, given the uptake of value based models for kidney care in the United States. Timing of dialysis start is influenced by patients' clinical status and complex patient-clinician interactions. Patients value personal freedom and quality of life and may want to delay dial-ysis, whilst physicians are sometimes more concerned with clinical outcomes. Kidney-preserving therapy can prolong the dialysis-free period and preserve residual kidney function, thus patients are asked to adjust their lifestyle and diet, to follow a low-or very low-protein diet, with or without ketoacid analogues. Multi-modal approaches include pharmacotherapies, management of symptoms, and a gradual, individualized dialysis transition. Patient empowerment is vital, including CKD education and involvement in decision making. These ideas may help patients, their families, and clinical teams to improve the management of CKD.

Keywords

Chronic kidney disease, Nutrition, Low-protein diet, Ketoacid analogue supplements, Dialysis, Value-based models

Publication Title

Journal of Renal Nutrition

Divisions

fac_med

Funders

None

Volume

33

Issue

4

Publisher

W B Saunders Co-Elsevier Inc

Publisher Location

1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA

This document is currently not available here.

Share

COinS