Making sense of the latest KDOQI-AND guidelines for nutrition in CKD. Anthony Meade, Adv Renal APD
The Kidney Foundation’s Kidney Disease Outcomes Quality Initiative Clinical Practice Guideline for Nutrition in Chronic Kidney Disease was updated in 2020. It had not been updated since 2003 and a lot has changed in those 17 years. In Anthony’s presentation he steps us through the development of the guidelines and gives an expert clinicians interpretation of how to integrate the guidelines into clinical practice.
- A thorough patient assessment is important. Conclusions about our management should not be formed until our patient has been carefully assessed and listened to.
- Take into account the whole patient and everything about them including their symptoms and their goals. Make sure whatever we are recommending aligns with their goals.
- Diet quality is critical. If we are making diets more restrictive, we are missing the point about diet quality and we are not doing the right thing either clinically or by our patient. For example, if protein or phosphate is reduced, consider what that is doing to other nutrients, the overall quality of the diet and if the eating pattern which has been created is suitable for the patient.
- There is a trend toward a more plant dominated protein-controlled diet. We need to be very familiar with practical plant-based meal suggestions and recipes ideas.
- Wholegrains, fresh fruit and vegetables should be a regular part of the diet. Work with the patient to get that balance right. The less additives and ultra-processed foods the better.
- These guidelines are not perfect; they are based on available evidence. Their non-prescriptive nature is helpful because it frees us to use our clinical judgement.
Anthony Meade is an Advanced Renal Dietitian practising at Central Northern Adelaide Renal and Transplantation Service, based at Royal Adelaide Hospital, SA. Anthony is passionate about individualised, patient-centred care and making renal nutrition easier for people with kidney disease, their families and the clinicians caring for them. Anthony has a broad experience of all areas of renal nutrition and is an experienced clinical educator and convenor of the Renal Nutrition Program.
To register for the presentation and associated documents including the assessment quiz click here