Chronic kidney disease CKD is one of the most prevalent complications of diabetes, and patients with diabetic kidney disease DKD have a substantially higher risk of cardiovascular disease and death compared to their non-diabetic CKD counterparts. In addition to pharmacologic management strategies, nutritional and dietary interventions in DKD are an essential aspect of management with the potential for ameliorating kidney function decline and preventing the development of other end-organ complications. While guidelines recommend dietary sodium restriction to less than 1. Epidemiologic data show that the prevalence of diabetes is increasing worldwide, particularly in the United States US where While longitudinal data from the US show that the incidence of diabetic end-organ complications has declined over the past two decades [ 2 ], diabetes remains a major source of morbidity and mortality due to its staggering rise in prevalence [ 3 ]. Thus, two major goals in the management of diabetic kidney disease DKD are stabilization of kidney function and prevention of the development of other end-organ complications. Provision of balanced nutritional therapy, in conjunction with pharmacologic interventions that optimize glycemic status, lipid levels, and blood pressure, are cornerstones of the management of DKD patients [ 5 ]. In this review, we summarize current clinical practice guidelines and supporting evidence regarding the nutritional management of patients with DKD. While nutritional therapy is an essential aspect of the treatment of DKD, current clinical practice guidelines Figure 1 do not wholly address all areas of dietary management due to existing controversies and gaps in knowledge about particular interventions e. Furthermore, recommendations may differ across the stages of DKD due to differential risk-to-benefit ratio profiles of certain management strategies across varying levels of kidney function. For example, among advanced chronic kidney disease CKD and ESRD patients who may be susceptible to hypoglycemia, intensive glycemic control may be associated with heightened risk of adverse outcomes [ 6, 7 ].
COVID is an emerging, rapidly evolving situation. Get the latest public health information from CDC: Your choices about what to eat and drink while on hemodialysis can make a difference in how you feel and can make your treatments work better. Between dialysis treatment sessions, wastes can build up in your blood and make you sick. You can reduce waste buildup by controlling what you eat and drink. You can match what you eat and drink with what your kidney treatments remove. Some foods cause wastes to build up quickly between your dialysis sessions. If your blood contains too much waste, your kidney treatment session may not remove them all. Your dialysis center has a renal dietitian to help you plan your meals. A renal dietitian has special training in caring for the food and nutrition needs of people with kidney disease.
Toggle Sliding Bar Area. For hemodynamic changes induced by excess protein intake may also. More protein diabetic you need makes your dialysis work harder exert deleterious consequences over time. Sodium is found in many pts, packaged, frozen, and fast and may make CKD worse. Sodium restrictions diets be individualized.