Research related to the time requirements for medical nutrition therapy (MNT) provided by a Registered Dietitian (RD) indicate that approximately two hours per month for up to one year may be required to provide an effective intervention for adults with chronic kidney disease. Medical nutrition therapy should be initiated at least twelve months prior to the anticipation of renal replacement therapy (dialysis or transplant). Studies regarding effectiveness of MNT report significant improvements in anthropometric and biochemical measurements sustained greater than or equal to one year.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.