Nutritional management of chronic renal disease

The importance of nutritional evaluation and diet therapy in the overall management of the patient with chronic renal disease is unquestioned. Its application often is limited by a lack of knowledge regarding the requirement for certain nutrients in health as well as the way in which these requirements are modified by chronic disease. However, the most important and often the most difficult task is engaging the cooperation of the patient in the nutritional management of his disease. Acceptance of dietary manipulation depends upon the patient's family structure and the importance of food and mealtime within the particular cultural and ethnic background. Dietary recommendations implemented by the parents of pediatric patients may produce untoward changes in the child's behavior, attitudes toward food, or relationships with other family members. Dietary recommendations must be carefully planned and their effect reevaluated. They should be individualized to the age, intellectural skills, and developmental stage of the patient.