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Low protein diets and nutritional therapies in CKD: investigating the current global trends

Nutritional interventions in chronic kidney disease (CKD) have been met with mixed reports. Strong supporters and determined adversaries have contributed to the controversy, reflecting changes in the near-world of renal replacement therapies, and the wider-world of nutrition.  While the support and cooperation between nephrologists, nutritionists and dieticians is the winning (gold- standard) solution in developed countries, it is important to remember that dietary treatment of CKD was an important skill for a nephrologist to have, and that regaining this expertise may be the best strategy for low-income countries, in which a lack of resources limits the offer of care.

This special issue focuses on low-protein diets as part of the “medical management” of CKD but is also open to other aspects of the clinical management of advanced CKD patients.  We have made available, along with regular research and review papers, a series of practical strategies, counsels, and suggestions, as well as examples of dietary schemas given to patients.

This special series has been partially sponsored by Fresenius Kabi.  All contributing authors, reviewers, and editors are fully independent of the sponsor.

Edited by: Dr Giorgina Piccoli, Dr Adamasco Cupisti, Dr Hayley Henderson

 

  1. Debate

    Diet in chronic kidney disease in a Mediterranean African country

    Mediterranean diet is characterized by low to moderate consumption of animal protein and high consumption of fruits, vegetables, bread, beans, nuts, seeds and other cereals. It has been associated with reduced...

    Khawla Kammoun, Hanen Chaker, Hichem Mahfoudh, Nouha Makhlouf, Faical Jarraya and Jamil Hachicha

    BMC Nephrology 2017 18:34

    Published on: 23 January 2017

  2. Research article

    Correction of metabolic acidosis improves insulin resistance in chronic kidney disease

    Correction of metabolic acidosis (MA) with nutritional therapy or bicarbonate administration is widely used in chronic kidney disease (CKD) patients. However, it is unknown whether these interventions reduce i...

    Antonio Bellasi, Lucia Di Micco, Domenico Santoro, Stefania Marzocco, Emanuele De Simone, Mario Cozzolino, Luca Di Lullo, Pasquale Guastaferro and Biagio Di Iorio

    BMC Nephrology 2016 17:158

    Published on: 22 October 2016

  3. Case report

    Compliance, illiteracy and low-protein diet: multiple challenges in CKD and a case of self-empowerment

    Low-protein diets (LPD) are an important means of delaying the need for dialysis and attaining a stable metabolic balance in chronic kidney disease (CKD). Many authors consider a low educational level and illi...

    Stefania Maxia, Valentina Loi, Irene Capizzi, Giorgina Barbara Piccoli, Gianfranca Cabiddu and Antonello Pani

    BMC Nephrology 2016 17:138

    Published on: 29 September 2016

  4. Research article

    Vegan-vegetarian low-protein supplemented diets in pregnant CKD patients: fifteen years of experience

    Pregnancy in women with advanced CKD becoming increasingly common. However, experience with low-protein diets in CKD patients in pregnancy is still limited.

    Rossella Attini, Filomena Leone, Silvia Parisi, Federica Fassio, Irene Capizzi, Valentina Loi, Loredana Colla, Maura Rossetti, Martina Gerbino, Stefania Maxia, Maria Grazia Alemanno, Fosca Minelli, Ettore Piccoli, Elisabetta Versino, Marilisa Biolcati, Paolo Avagnina…

    BMC Nephrology 2016 17:132

    Published on: 20 September 2016

  5. Research article

    Very low protein diets supplemented with keto-analogues in ESRD predialysis patients and its effect on vascular stiffness and AVF Maturation

    Native arteriovenous fistula (AVF) is the most appropriate type of vascular access for chronic dialysis. Its patency rates depend on vascular wall characteristics. Ketoacid analogues of essential amino acids (...

    Cristiana David, Ileana Peride, Andrei Niculae, Alexandra Maria Constantin and Ionel Alexandru Checherita

    BMC Nephrology 2016 17:131

    Published on: 20 September 2016

  6. Correspondence

    A practical approach to low protein diets for patients with chronic kidney disease in Cameroon

    Cameroon is a low–middle income country with a rich diversity of culture and cuisine. Chronic kidney disease (CKD) is common in Cameroon and over 80 % of patients present late for care, precluding the use of t...

    Gloria Enow Ashuntantang, Hermine Fouda, Francois Folefack Kaze, Marie-Patrice Halle, Crista Tabi-Arrey and Magloire Biwole-Sida

    BMC Nephrology 2016 17:126

    Published on: 7 September 2016

  7. Research article

    Nutritional support in the tertiary care of patients affected by chronic renal insufficiency: report of a step-wise, personalized, pragmatic approach

    Dietary treatment is helpful in CKD patients, but nutritional interventions are scarcely implemented. The main concern of the renal diets is its feasibility with regards to daily clinical practice especially i...

    Adamasco Cupisti, Claudia D’Alessandro, Biagio Di Iorio, Anna Bottai, Claudia Zullo, Domenico Giannese, Massimiliano Barsotti and Maria Francesca Egidi

    BMC Nephrology 2016 17:124

    Published on: 6 September 2016

  8. Correspondence

    “Dietaly”: practical issues for the nutritional management of CKD patients in Italy

    Evidence exists that nutritional therapy induces favorable metabolic changes, prevents signs and symptoms of renal insufficiency, and is able to delay the need of dialysis. Currently, the main concern of the r...

    Claudia D’Alessandro, Giorgina Barbara Piccoli, Patrizia Calella, Giuliano Brunori, Franca Pasticci, Maria Francesca Egidi, Irene Capizzi, Vincenzo Bellizzi and Adamasco Cupisti

    BMC Nephrology 2016 17:102

    Published on: 29 July 2016

  9. Correspondence

    A practical approach to a low protein diet in Brazil

    Chronic kidney disease (CKD) is an emerging health public problem in Brazil. Nutritional counseling with focus on protein restriction is a promising strategy to treatment of nondialysis CKD patients due its ef...

    Denise Mafra and Viviane O. Leal

    BMC Nephrology 2016 17:105

    Published on: 29 July 2016

  10. Correspondence

    North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease

    Whereas in many parts of the world a low protein diet (LPD, 0.6-0.8 g/kg/day) is routinely prescribed for the management of patients with non-dialysis-dependent chronic kidney disease (CKD), this practice is i...

    Kamyar Kalantar-Zadeh, Linda W. Moore, Amanda R. Tortorici, Jason A. Chou, David E. St-Jules, Arianna Aoun, Vanessa Rojas-Bautista, Annelle K. Tschida, Connie M. Rhee, Anuja A. Shah, Susan Crowley, Joseph A. Vassalotti and Csaba P. Kovesdy

    BMC Nephrology 2016 17:90

    Published on: 19 July 2016

  11. Correspondence

    A practical approach to low protein diets in Sweden– 45 years of clinical use

    This review provides an overview of the development, implementation and practise of low protein diets (LPD) in Sweden. While the current practice is discussed in general terms emphasizing the interplay between...

    Sintra Eyre, Gerd Faxén-Irving, Per-Ola Attman, Marie Evans, Karin Windahl, Sigrid Wegener, Charlotte Andersén, Karin Nykvist-Raanaes, Sara Einemo and Juan-Jesus Carrero

    BMC Nephrology 2016 17:89

    Published on: 19 July 2016

  12. Correspondence

    A practical approach to dietary interventions for nondialysis-dependent CKD patients: the experience of a reference nephrology center in Brazil

    This paper describes the 30-year experience on nutritional management of non-dialysis dependent chronic kidney disease (CKD) patients in a public outpatient clinic located in the city of São Paulo, Brazil. A t...

    Lilian Cuppari, Fabiana Baggio Nerbass, Carla Maria Avesani and Maria Ayako Kamimura

    BMC Nephrology 2016 17:85

    Published on: 16 July 2016

  13. Correspondence

    Low-protein diets for chronic kidney disease patients: the Italian experience

    Nutritional treatment has always represented a major feature of CKD management. Over the decades, the use of nutritional treatment in CKD patients has been marked by several goals. The first of these include t...

    Vincenzo Bellizzi, Adamasco Cupisti, Francesco Locatelli, Piergiorgio Bolasco, Giuliano Brunori, Giovanni Cancarini, Stefania Caria, Luca De Nicola, Biagio R. Di Iorio, Lucia Di Micco, Enrico Fiaccadori, Giacomo Garibotto, Marcora Mandreoli, Roberto Minutolo, Lamberto Oldrizzi, Giorgina B. Piccoli…

    BMC Nephrology 2016 17:77

    Published on: 11 July 2016

  14. Review

    Low protein diets in patients with chronic kidney disease: a bridge between mainstream and complementary-alternative medicines?

    Dietary therapy represents an important tool in the management of chronic kidney disease (CKD), mainly through a balanced reduction of protein intake aimed at giving the remnant nephrons in damaged kidneys a “...

    Giorgina Barbara Piccoli, Irene Capizzi, Federica Neve Vigotti, Filomena Leone, Claudia D’Alessandro, Domenica Giuffrida, Marta Nazha, Simona Roggero, Nicoletta Colombi, Giuseppe Mauro, Natascia Castelluccia, Adamasco Cupisti and Paolo Avagnina

    BMC Nephrology 2016 17:76

    Published on: 8 July 2016

  15. Research article

    Efficacy of the Essential Amino Acids and Keto-Analogues on the CKD progression rate in real practice in Russia - city nephrology registry data for outpatient clinic

    Renal replacement therapy (RRT) is growing by 10 % per year in Russia, but pre-dialysis care which can retard CKD progression and delay the start of RRT remains limited. We evaluate the effect of Essential Ami...

    Alexander Zemchenkov and Irina N. Konakova

    BMC Nephrology 2016 17:62

    Published on: 7 July 2016

  16. Review

    Adherence to ketoacids/essential amino acids-supplemented low protein diets and new indications for patients with chronic kidney disease

    Low protein diets (LPD) have long been prescribed to chronic kidney disease patients with the goals of improving metabolic abnormalities and postpone the start of maintenance dialysis.

    Denis Fouque, Jing Chen, Wei Chen, Liliana Garneata, SJ Hwang, Kamyar Kalantar-Zadeh, Joel D. Kopple, William E. Mitch, Giorgina Piccoli, Vladimir Teplan and Philippe Chauveau

    BMC Nephrology 2016 17:63

    Published on: 7 July 2016

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