Typical diets for kidney disease primarily focus on the restriction of potassium, phosphorus, sodium and calcium. However, recent research and guidelines highlight that the traditional renal diet is no longer considered evidence-based and more nutrient dense dietary food patterns provide more optimal health outcomes for those with CKD or on dialysis. This encourages dietitians to focus on nourishing the patient rather than dietary restriction.
Knowing appropriate vitamin and mineral recommendations for those with CKD is challenging due to:
- Not all clinicians are familiar with the latest guidelines/ recommendations
- There is a history of fear with regards to micronutrients and CKD
- Limited high quality published data (which is why clinical judgement is so key!)
- Limited time to do all the research and reading to provide confident recommendations to patients
These clinical guides provide easy and quick recommendations for dietitians working in the CKD population to better assess and intervene to support their patient’s nutritional needs in the context of CKD. References are included with both guides, as well as a resource page for learning more about micronutrient testing.
The mineral clinical guide includes 11 minerals and:
- RDA and CKD recommendations (if available)
- Tests used to assess nutriture
- Signs of deficiency or toxicity
- CKD alterations or considerations
- Intervention suggestions for high or low levels (which includes specific dosage, optimal forms, and root causes to consider)
The vitamin clinical guide includes 14 vitamins and:
- RDA/ AI/ CKD recommendations (if available)
- Tests used to assess
- Signs of deficiency
- CKD alterations
- Interventions
*toxicity symptoms and interventions were not included here due to lack of data on toxicity actually occurring except with a few published cases on Vitamin D.
Both of these guides are available in the Kidney Nutrition Institute courses for vitamins and minerals in CKD.
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