Nutritional interventions in elderly pre-dialysis patients

Abstract

Dietary protein restriction is recommended in pre-dialysis patients with chronic kidney disease (CKD), and its major purpose is preventing the progression to end-stage renal disease (ESRD), which was determined based on evidence of renal prognosis and survival in mostly young and middle-aged patients. In contrast, elderly people have been recommended to consume higher protein intake to maintain and regain muscle mass and strength compared to younger people. Protein restriction to prevent CKD progression and the recommended protein intake to prevent or improve sarcopenia and/or frailty are incompatible at this time. Sufficient energy intake is needed in patients with CKD with protein restriction and sarcopenia. Here, we discuss nutritional interventions with a focus on dietary protein intake in elderly pre-dialysis patients with CKD.