UPDATES IN RENAL NUTRITION

UPDATES IN RENAL NUTRITION

RACHAEL R. MAJOROWICZ, RDN, CSR, LD, FNKF

Disclosures

? None

Learning Outcomes

? List at least three changes to nutrition practice guidelines for patients with kidney disease.

? Educate patients based on the updated evidence-based nutrition therapy recommendations for adults with kidney disease.

? Implement the findings from the evidence-based nutrition therapy recommendations into practice with chronic kidney disease patients.

NKF-KDOQI and Academy-EAL collaboration on CKD Guideline Work Group

? Co-Chairs: T. Alp Ikizler, MD & Lillian Cuppari, PhD ? Macronutrients

? Laura Byham-Gray, PhD, RDN, FNKF (Chair) ? Denis Fouque, MD, PhD ? Winnie Chan, PhD, RD ? Jerrilynn Burrowes, PhD, RD, CDN ? Daniel Teta, MD, PhD ? Micronutrients ? Angela Wang, MD, PhD (Chair) ? Jordi Fuchs, DSc, APN,NP-C,RD ? Joel Kopple, MD ? Sana Ghaddar, PhD, RDN ? Alp Ikizler, MD ? Electrolytes & other nutrients ? Juan Jesus Carrero, PhD Pharm, PhD Med, MBA (Chair) ? Katrina Campbell, PhD, RD ? George Kaysen, MD, PhD ? Allon Friedman, MD, FASN ? Lilian Cuppari, PhD

Guideline Objectives

? Target Population Adult = 19+ All genders CKD 1-5 and transplant X Excluded: AKI and Critical Illness

? Limiting Factors

? Inconsistent reporting of clinical outcomes ? Low quality evidence in certain areas ? Issues with nutrition studies: nutrient status, confounding

variables...

UPDATED INTERVENTION RECOMMENDATIONS

Evolution of Nutrition Needs

KDOQI 2000-2007

Energy Needs 30-35 kcal/kg (O)

Protein

0.6-0.75 g/kg CKD 0.8 g/kg in CKD & DM 1.2-1.3 g/kg in HD-PD

Sodium

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