KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update

Aug 25, 2020American journal of kidney diseases : the official journal of the National Kidney Foundation

Updated Nutrition Guidelines for Chronic Kidney Disease Care (2020)

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Abstract

The 2020 KDOQI Clinical Practice Guideline for Nutrition in CKD includes updated recommendations for patients across all stages of chronic kidney disease.

The guidelines encompass patients with stages 1-5 CKD, not just those receiving dialysis or with end-stage kidney disease.
Key areas addressed include nutritional assessment, medical nutrition therapy, dietary protein and energy intake, nutritional supplementation, micronutrients, and electrolytes.
Evidence for the guidelines was evaluated using GRADE criteria to ensure quality and reliability.
Each recommendation is supported by rationale, monitoring guidance, and considerations for implementation.
The updates reflect the significant accumulation of evidence since the first KDOQI guideline was published in 1999.

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The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for nutrition in kidney diseases since 1999. Since the publication of the first KDOQI nutrition guideline, there has been a great accumulation of new evidence regarding the management of nutritional aspects of kidney disease and sophistication in the guidelines process. The 2020 update to the KDOQI Clinical Practice Guideline for Nutrition in CKD was developed as a joint effort with the Academy of Nutrition and Dietetics (Academy). It provides comprehensive up-to-date information on the understanding and care of patients with chronic kidney disease (CKD), especially in terms of their metabolic and nutritional milieu for the practicing clinician and allied health care workers. The guideline was expanded to include not only patients with end-stage kidney disease or advanced CKD, but also patients with stages 1-5 CKD who are not receiving dialysis and patients with a functional kidney transplant. The updated guideline statements focus on 6 primary areas: nutritional assessment, medical nutrition therapy (MNT), dietary protein and energy intake, nutritional supplementation, micronutrients, and electrolytes. The guidelines primarily cover dietary management rather than all possible nutritional interventions. The evidence data and guideline statements were evaluated using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. As applicable, each guideline statement is accompanied by rationale/background information, a detailed justification, monitoring and evaluation guidance, implementation considerations, special discussions, and recommendations for future research.

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KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update

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