KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update.

Area of Science:

• Nephrology
• Clinical Nutrition

Background:

• The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has updated its nutrition guidelines for chronic kidney disease (CKD).
• Significant new evidence and advancements in guideline development informed this 2020 update, a collaboration with the Academy of Nutrition and Dietetics.

Framework:

• The updated guidelines provide comprehensive, evidence-based information on the metabolic and nutritional care of patients with CKD stages 1-5, end-stage kidney disease, and kidney transplant recipients.
• Guideline statements focus on six core areas: nutritional assessment, medical nutrition therapy (MNT), dietary protein and energy intake, nutritional supplementation, micronutrients, and electrolytes.
• The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria were used to evaluate evidence and guideline statements.

Implementation:

• Each guideline statement includes rationale, justification, monitoring and evaluation guidance, and implementation considerations.
• The guidelines emphasize dietary management strategies for clinicians and allied health professionals.
• Recommendations for future research are also provided.

Implications:

• These updated guidelines aim to improve the understanding and care of patients with CKD by providing actionable, evidence-based nutritional strategies.
• The comprehensive nature of the guidelines supports a broader application across different stages of CKD and post-transplant care.
• Enhanced focus on nutritional assessment and MNT is expected to optimize patient outcomes.