Classification and Definition
Screening, Assessment and Concerns
- Estimated prevalence of CKD is 14% of the US population (40 million adults, or 1 in 10). Most people are unaware. (see table below)
- People with high risk factors should be screened regularly. Risk Factors include diabetes, hypertension, heart disease, family hx of CKD, age 60+, obesity, autoimmune diseases, frequent UTIs, overuse of OTC painkillers, kidney damage or injury
- US Preventative Services Task Force finds insufficient evidence to determine harms or benefits for screening in asymptomatic adults. Download recommendation details
- Nutrition Assessment: Medical history (risk factors, drug/nutrient interactions), diet history, food security, biochemical data (see NKD website on lab values associated with CKD), anthropometrics (ht, wt, signs of nutrient deficiencies)
Diagnosis Criteria and Procedures
- NIH website on Identifying and Evaluating patients with CKD
- The two markers of CKD are urine albumin and GFR
Medical Nutrition Therapy and Goals
- Goals: Treat underlying disease, delay progression, prevent complications
- MNT: The NFK KDOQI Clinical Practice Guidelines for all stages of CKD
- Patient education and goals
Nutrition Recommendations
Nutrition Recommendation Resources
Pharmacological Management
Complications
- NIDDK handout on potassium foods
- NKDEP handout on phosphorus foods and NFK KDOQI Guidelines for using Phosphate binders
- NKD recommendations for flavoring foods without using sodium
- NFK pamphlet on Nutrition and Hemodialysis
- NFK website on nutrition and peritoneal dialysis
- NFK pamphlet on nutrition and renal transplantation
Pharmacological Management
- NFK website of commonly prescribed drugs
- NIH website on hemodialysis
- NFK website on peritoneal dialysis
- Medline Plus website on kidney transplant
Complications
- Cardiovascular disease - CKD pts are more likely to die of CVD than progress to stage 4. Includes heart failure and atherosclerosis
- Secondary hyperparathyroidism - restrict phosphorus and supplement with vitamin D
- Anemia - treat with rHuEPO and iron supplementation