Diet and enteral nutrition in patients with chronic kidney disease not on dialysis: a review focusing on fat, fiber and protein intake

Alice Sabatino, Giuseppe Regolisti, Ilaria Gandolfini, Marco Delsante, Filippo Fani, Maria Cristina Gregorini, Enrico Fiaccadori

Research output: Contribution to journalReview article

Abstract

The clinical data available on dietary requirements of patients with chronic kidney disease (CKD) not on dialysis are limited and largely inconclusive in terms of the renal, cardiovascular and nutritional outcomes achievable through dietary modifications. Restriction of protein intake during the early stages of CKD may in fact slow its progression, but at the same time this approach may also lead to protein-energy wasting, if energy intake is not adequate and properly monitored. Unfortunately, compliance to dietary recommendations is traditionally low in this patient population. A switch from saturated to mono- and polyunsaturated fats is generally recognized as advantageous for cardiac health; however, the benefits in term of renal function are largely unknown. Similarly, the association between dietary fiber intake and kidney disease is largely unknown. In fact, while there is evidence on the positive health effects of dietary fibers in the general population, nutritional guidelines for CKD lack formal recommendations concerning fiber intake. This paper reviews data and evidence from clinical trials and meta-analyses on renal and cardiovascular outcomes related to modifications in protein, fat and fiber intake. Suggestions for maintaining nutritional status through patient-oriented dietary patterns and enteral supplementation in CKD patients on conservative therapy are also presented.

Original languageEnglish
Pages (from-to)743-754
Number of pages12
JournalJournal of Nephrology
Volume30
Issue number6
DOIs
Publication statusPublished - Dec 1 2017
Externally publishedYes

Keywords

  • Chronic kidney disease
  • Conservative treatment
  • Enteral nutrition
  • Nutritional support
  • Protein energy wasting
  • Renal diet

ASJC Scopus subject areas

  • Nephrology

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    Sabatino, A., Regolisti, G., Gandolfini, I., Delsante, M., Fani, F., Gregorini, M. C., & Fiaccadori, E. (2017). Diet and enteral nutrition in patients with chronic kidney disease not on dialysis: a review focusing on fat, fiber and protein intake. Journal of Nephrology, 30(6), 743-754. https://doi.org/10.1007/s40620-017-0435-5