Nutritional management of kidney diseases: an unmet need in patient care
- PDF / 364,749 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 74 Downloads / 167 Views
EDITORIAL
Nutritional management of kidney diseases: an unmet need in patient care Adamasco Cupisti1 · Carla Maria Avesani2 · Claudia D’Alessandro1 · Giacomo Garibotto3
© Italian Society of Nephrology 2020
Patients with kidney disease have unmet needs with regard to nutritional care throughout the world. This multi-layered issue arises from different, mainly educational, causes; one of them is that nutritional management is rarely included in the core curriculum of young nephrologists, and on the counterpart, detailed information on the management of the different phases of chronic kidney disease (CKD) is not systematically included in the educational programs of dietitians. Moreover, only a few specialized educational programs for “renal dietitians” are available in Europe. Since nutritional care exists in a delicate balance between two great paradigms, which are the need for standardization and for personalized medicine, there is great demand for an organized and systematic nutritional approach to complement the study programs of nephrologists and dietitians alike. In order to ensure the most valid approach, sharing scientific knowledge as well as clinical expertise and practice guidelines are paramount to achieving a good level of cooperation between nephrologists and dieticians. It is noteworthy that knowledge of the nutritional aspects of kidney diseases, ranging from understanding the metabolic derangements related to nutritional disturbances to optimizing dietary regimens in kidney disease patients, has seen great progress in the last decades as exemplified in the upcoming New Clinical Practice Guideline for Nutrition in CKD 2020 of the National Kidney Foundation (NKF)/ Kidney Disease Outcomes Quality Initiative (KDOQI) and Academy of Nutrition and Dietetics. As compared to the * Adamasco Cupisti [email protected] 1
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
2
Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
3
Division of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
previous guidelines published in the year 2000, there is increased attention to nutritional assessment (new methods and tools for body composition evaluation), to the role of dietary patterns as related to clinical outcomes, and to the effects of low protein diets (while maintaining an adequate nutritional status) in delaying the start of renal replacement therapy. Furthermore, there is an expanded section on phosphate and potassium metabolism. However, evidence of the efficacy of nutritional intervention is not so strong and could be undetermined by methodological issues such as lack of randomized controlled studies and great compliance variability in the few available trials [1]. The role of observational studies is controversial. This being said, the progress that has been made in this field has enabled a better nutritional care appr
Data Loading...
