Abstract
Background: Excessive dietary habits may contribute to kidney function deterioration in Chronic Kidney Disease (CKD). Diet modifications have been used to slow kidney function deterioration. We reviewed the results of dietetic interventions in the outcomes of CKD.
Methods: Revision of clinical trials and meta-analysis reporting the results of dietetic interventions, published until March 2015 in journals indexed in Pubmed/Medline.
Results: moderate protein restriction (0.8 g/Kg/day) may slow the progression of CKD in stages 4-5. There is no evidence supporting protein restriction in CKD stage 3, or there is no advantage more protein restriction in advanced CKD stages. Severe protein restriction can contribute to Protein Energy Wasting (PEW). Restricting sodium intake to 80-100 m Mol/day helps to control hypertension, albuminuria and oedema. However, there is no evidence that sodium restriction prolongs kidney survival. Restricting phosphate intake is not necessary in CKD stage 3-4 and may also contribute to PEW. When necessary, in CKD stage 5 before kidney replacement therapy, hyperphosphatemia can be controlled with phosphate chelating agents. There is limited evidence that fruits and vegetables can control metabolic acidosis and slow CKD progression.
Conclusion: The evidences that dietetic interventions can slow the progression of CKD are weak. Randomized controlled trials searching for hard clinical outcomes and longer follow-up time are necessary before recommending restrictive dietetic interventions.
Citation
Domingos F. Diet and Clinical Outcomes in Chronic Kidney Disease Stages 3-5: Need for Evidence-Based Interventions. SM J Food Nutri Disord. 2015; 1(2): 1008.