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Chronic Kidney Disease (CKD)
Sustained decline in kidney function (eGFR <60 mL/min/1.73 m² or markers of damage for >3 months), staged 1-5 by eGFR, with nutritional management central to slowing progression and managing comorbidities.
Also: CKD
Nutritional issues: protein restriction (0.6-0.8 g/kg/d in stages 3-5 without dialysis to slow progression; ≥1.2 g/kg/d on dialysis); phosphate restriction with binders; potassium restriction in late stages; sodium <2,300 mg/d for blood pressure; adequate calorie intake to prevent protein-energy wasting; plant-dominant diet associated with slower progression and lower acid load. Vitamin D deficiency, secondary hyperparathyroidism, and FGF23 elevation drive CKD-mineral bone disorder (CKD-MBD).
How each textbook covers it
Krause and Mahan's Food and the Nutrition Care Process, 16th ed. — Chapter 35
Stage 1 has normal eGFR (>=90) with markers of damage; Stage 5 (end-stage renal disease, ESRD) has eGFR <15 and typically requires dialysis or transplant. Diabetes and hypertension are the leading causes. CKD raises cardiovascular risk and causes mineral and bone disorder, anemia, acidosis, and protein-energy wasting. MNT is tailored to stage and modality.
Modern Nutrition in Health and Disease, 12th ed. — Ch 96: Nutrition, Diet, and the Kidney
Nutritional issues: protein restriction (0.6-0.8 g/kg/d in stages 3-5 without dialysis to slow progression; ≥1.2 g/kg/d on dialysis); phosphate restriction with binders; potassium restriction in late stages; sodium <2,300 mg/d for blood pressure; adequate calorie intake to prevent protein-energy wasting; plant-dominant diet associated with slower progression and lower acid load. Vitamin D deficiency, secondary hyperparathyroidism, and FGF23 elevation drive CKD-mineral bone disorder (CKD-MBD).
Related terms
End-Stage Renal Disease, FGF23, Hemodialysis, PTH, Phosphate, Protein-energy wasting, Renal Diet