Recomendaciones prácticas para el manejo nutricional de la enfermedad renal crónica en etapas 3 a 5 con y sin diálisis para adultos y personas mayores en Chile

Abstract

Introduction: chronic kidney disease (CKD) is an important public health problem. It is estimated that approximately 12 % of the population suffers from it and presents high cardiovascular morbidity and mortality and health costs. Timely and adequate attention implies benefits that delay the progression of the disease and its complications. Current evidence concludes that medical-nutritional therapy favors beneficial metabolic changes for the progression of CKD and that the benefits of implementing a process of individualized nutritional care in these people, allow support in the control of glomerular hyperfiltration, proteinuria, waste accumulation, water and electrolyte control, metabolic acidosis and associated symptomatology. As well as the detection, prevention and management of protein energy wasting syndrome, uremia-related symptomatology, and the delay of renal replacement therapy. These strategies consider protein restriction, reduction of dietary acid load, increased water intake and control of specific nutrients such as potassium, sodium, and phosphorus. Recently, several beneficial dietary patterns have been described for the management and protection of CKD, among which the Mediterranean diet and the plant-based diet stand out. Therefore, the purpose of this review is to describe specific, updated, and simplified nutritional guidelines to promote the nutritional management of CKD and renal replacement therapies favoring quality nutritional care in health care teams.