Dietary Recommendations In Chronic Kidney Disease (A Practical Guide For The Patient)

Chronic kidney disease (CKD) is a permanent impairment of kidney function and/or structure with a duration of more than 3 months. It affects more than 10% of the global population, amounting to more than 800 million people. According to the Bul-garian Society of Nephrology, nearly 13% of Bulgarian citizens have chronic kidney disease. It is one of the leading causes of mortality worldwide and is one of the few non-communicable diseases that have seen an increase in associated deaths over the past two decades. The role of diet therapy is to slow the progression of CKD and uremia has been recommended for more than a century. As renal function declines, waste products and excessive amounts of electrolytes accumulate, which can significantly impair patients‘ health. Diet in these patients controls uremic symptoms and provides a beneficial effect on the progression of renal dysfunction. Restricting protein intake is advisable, as excessive consumption can aggravate kidney disease. Excessive sodium intake may be associated with disease progression and increased mortality in patients, therefore salt restriction is necessary. Low po-tassium is associated with muscle weakness and hypertension, while high potassium levels lead to cardiac arrhythmia. Individ-ualization of potassium intake is recommended to keep serum levels within normal limits. Proper dietary intake of calcium and phosphorus is involved in the regulation of calcium-phosphorus balance, especially in patients with advanced CKD. An energy intake in the range of 25-35 kcal/kg/24h is necessary, as well as what percentage of calories during the day will be obtained from fats and carbohydrates. It is also important to pay attention to regular physical activity in patients with CKD, reducing stress and limiting risk factors such as alcohol and smoking. Compliance with dietary recommendations in chronic kidney disease and its effective management is challenging. Individ-ualized strategies are needed to ensure the best outcome for patients with kidney disease.