Practical Guide to Nutritional Assessment in CKD: Current Tools, Emerging Technologies, and Future Directions

Nutritional disorders and malnutrition are common in people living with CKD, and the provision of individualized dietary advice is an established therapy for the management of CKD. The complex relationship between nutrition and outcomes in CKD necessitates a comprehensive understanding of assessment tools and management strategies. The nutritional status of individuals with CKD is affected by the progression of CKD as well as treatments provided. In turn, careful management of the nutritional status of individuals with CKD can attenuate progression of kidney failure, reduce CKD-related complications, and also improve the individual's health-related quality of life. This review examines traditional and emerging approaches to nutritional evaluation of people with CKD, with a particular emphasis on their practical implementation and impact on patient care. The five components of nutrition assessment including physical measures, biochemistry, clinical history, nutrition, and functional assessment will be described with a focus on integration of multiple data sources for comprehensive evaluation. This is particularly valuable in resource-constrained settings. Consideration is given to nutritional assessment across the lifespan together with the identification of nutrition-related issues that require intervention. Novel strategies that provide additional insights into the nutritional status of individuals will be highlighted. We conclude by providing practical guidance for physicians implementing nutrition assessment in various clinical settings.