National Kidney Foundation, Academy Release Clinical Practice Guidelines on Nutrition

August 20, 2020

New York, NY — The National Kidney Foundation (NKF) in collaboration with the Academy of Nutrition and Dietetics released today the 2020 Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline on Nutrition in Chronic Kidney Disease that will guide health care practitioners who treat people with all stages of kidney disease.

KDOQI, which pioneered evidence-based clinical practice guidelines for improving the diagnosis and treatment of kidney disease, first published guidelines on nutrition for patients with end-stage kidney disease in 2000. This comprehensive update has been expanded to include nutritional management of patients with stages 1-5 chronic kidney disease and patients with a functioning transplant. It addresses six primary areas: nutritional assessment; medical nutrition therapy; dietary protein and energy intake; nutritional supplementation; micronutrients; and electrolytes.

"Global adoption and implementation of the KDOQI guidelines has dramatically changed all aspects of chronic kidney disease care in the years since the original nutrition guideline was published," said NKF Chief Scientific Officer Kerry Willis, Ph.D. "This guideline update reflects the numerous advances in both guideline development and dietary management of patients with chronic kidney disease over the past 20 years. We at NKF take great pride in the role KDOQI has played, and will continue to play, in moving the field forward and improving patient care."

The guideline includes practical clinical recommendations as well as insights on those nutrition questions still not fully understood. For example, the guideline states that there is currently insufficient evidence to make a recommendation on the type of protein – plant versus animal – that is best for all patients with chronic kidney disease. Although plant-based diets may have benefits for many patients, further research is recommended to better understand their effects on clinical outcomes.

"These guidelines will be a valuable tool for registered dietitian nutritionists in administering medical nutrition therapy to patients with chronic kidney disease (CKD), which will result in timely and accurate assessment of malnutrition, evidenced-based nutrition interventions and improved patient outcomes," said Alison Steiber, PhD, RDN, LD, chief science officer for the Academy of Nutrition and Dietetics.

The international, multidisciplinary workgroup was chaired by T. Alp Ikizler, MD, Vanderbilt University Medical Center, Nashville, and Lillian Cuppari, PhD, Oswaldo Ramos Foundation-Hrim Federal University of Sao Paulo, Brazil.

"Nutritional abnormalities are the hallmark of kidney disease and diet plays an important role in the day to day management of patients with CKD," said Dr. Ikizler. "The updated guidelines reflect the significant improvements in the understanding and care of patients with CKD in terms of their metabolic and nutritional milieu. We are hopeful that our colleagues will embrace these guidelines and implement them into their practice in the most effective way to improve the lives of those with CKD."

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Kidney Disease Facts

In the United States, 37 million adults are estimated to have chronic kidney disease – and approximately 90 percent don't know they have it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include: diabetes, high blood pressure, heart disease, obesity, and family history. People of African American, Hispanic, American Indian, Asian, or Pacific Islander descent are at increased risk for developing the disease. African Americans are almost 4 times more likely than White Americans to have kidney failure. Hispanics are 1.3 times more likely than non-Hispanics to have kidney failure.

NKF Professional Membership

Healthcare professionals can join NKF to receive access to tools and resources both patients and professionals, discounts on professional education, and access to a network of thousands of individuals who treat patients with kidney disease.

About the National Kidney Foundation

The National Kidney Foundation is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention,

About the Academy of Nutrition and Dietetics

Representing more than 100,000 credentialed nutrition and dietetics practitioners, the Academy of Nutrition and Dietetics is the world's largest organization of food and nutrition professionals. The Academy is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy. Visit the Academy at www.eatright.org.