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"Dietaly": practical issues for the nutritional management of CKD patients in Italy.
BMC Nephrol. 2016 07 29; 17(1):102.BN

Abstract

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 renal diets has turned from the efficacy to the feasibility in the daily clinical practice.Herewith we describe some different dietary approaches, developed in Italy in the last decades and applied in the actual clinical practice for the nutritional management of CKD patients.A step-wise approach or simplified dietary regimens are usually prescribed while taking into account not only the residual renal function and progression rate but also socio-economic, psychological and functional aspects.The application of the principles of the Mediterranean diet that covers the recommended daily allowances for nutrients and protein (0.8 g/Kg/day) exert a favorable effect at least in the early stages of CKD. Low protein (0.6 g/kg/day) regimens that include vegan diet and very low-protein (0.3-0.4 g/Kg/day) diet supplemented with essential amino acids and ketoacids, represent more opportunities that should be tailored on the single patient's needs.Rather than a structured dietary plan, a list of basic recommendations to improve compliance with a low-sodium diet in CKD may allow patients to reach the desired salt target in the daily eating.Another approach consists of low protein diets as part of an integrated menu, in which patients can choose the "diet" that best suits their preferences and clinical needs.Lastly, in order to allow efficacy and safety, the importance of monitoring and follow up of a proper nutritional treatment in CKD patients is emphasized.

Authors+Show Affiliations

Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56126, Pisa, Italy.Department of Clinical and Biological Sciences, University of Turin, Turin, Italy. Néphrologie, Centre hospitaler Le Mans, Le Mans, France.Department of Movement and Wellness Sciences, University of Naples Parthenope, Naples, Italy.Nephrology and Dialysis Unit, Trento Hospital, Trento, Italy.Nephrology and Dialysis Unit, USL Umbria 1, Perugia, Italy.Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56126, Pisa, Italy.Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.Division of Nephrology Dialysis & Transplantation, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56126, Pisa, Italy. adamasco.cupisti@med.unipi.it.

Pub Type(s)

Letter

Language

eng

PubMed ID

27473183

Citation

D'Alessandro, Claudia, et al. ""Dietaly": Practical Issues for the Nutritional Management of CKD Patients in Italy." BMC Nephrology, vol. 17, no. 1, 2016, p. 102.
D'Alessandro C, Piccoli GB, Calella P, et al. "Dietaly": practical issues for the nutritional management of CKD patients in Italy. BMC Nephrol. 2016;17(1):102.
D'Alessandro, C., Piccoli, G. B., Calella, P., Brunori, G., Pasticci, F., Egidi, M. F., Capizzi, I., Bellizzi, V., & Cupisti, A. (2016). "Dietaly": practical issues for the nutritional management of CKD patients in Italy. BMC Nephrology, 17(1), 102. https://doi.org/10.1186/s12882-016-0296-5
D'Alessandro C, et al. "Dietaly": Practical Issues for the Nutritional Management of CKD Patients in Italy. BMC Nephrol. 2016 07 29;17(1):102. PubMed PMID: 27473183.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - "Dietaly": practical issues for the nutritional management of CKD patients in Italy. AU - D'Alessandro,Claudia, AU - Piccoli,Giorgina Barbara, AU - Calella,Patrizia, AU - Brunori,Giuliano, AU - Pasticci,Franca, AU - Egidi,Maria Francesca, AU - Capizzi,Irene, AU - Bellizzi,Vincenzo, AU - Cupisti,Adamasco, Y1 - 2016/07/29/ PY - 2016/01/26/received PY - 2016/06/14/accepted PY - 2016/7/31/entrez PY - 2016/7/31/pubmed PY - 2017/12/5/medline KW - CKD KW - Dietary phosphorus KW - Dietary sodium KW - Dietary treatment renal insufficiency KW - Low-protein diet KW - Nutrition KW - Simplified diet SP - 102 EP - 102 JF - BMC nephrology JO - BMC Nephrol VL - 17 IS - 1 N2 - 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 renal diets has turned from the efficacy to the feasibility in the daily clinical practice.Herewith we describe some different dietary approaches, developed in Italy in the last decades and applied in the actual clinical practice for the nutritional management of CKD patients.A step-wise approach or simplified dietary regimens are usually prescribed while taking into account not only the residual renal function and progression rate but also socio-economic, psychological and functional aspects.The application of the principles of the Mediterranean diet that covers the recommended daily allowances for nutrients and protein (0.8 g/Kg/day) exert a favorable effect at least in the early stages of CKD. Low protein (0.6 g/kg/day) regimens that include vegan diet and very low-protein (0.3-0.4 g/Kg/day) diet supplemented with essential amino acids and ketoacids, represent more opportunities that should be tailored on the single patient's needs.Rather than a structured dietary plan, a list of basic recommendations to improve compliance with a low-sodium diet in CKD may allow patients to reach the desired salt target in the daily eating.Another approach consists of low protein diets as part of an integrated menu, in which patients can choose the "diet" that best suits their preferences and clinical needs.Lastly, in order to allow efficacy and safety, the importance of monitoring and follow up of a proper nutritional treatment in CKD patients is emphasized. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/27473183/"Dietaly":_practical_issues_for_the_nutritional_management_of_CKD_patients_in_Italy_ L2 - https://www.biomedcentral.com/1471-2369/17/102 DB - PRIME DP - Unbound Medicine ER -