Chronic Kidney Disease

Chronic Kidney Disease

Welcome to the Chronic Kidney Disease (CKD) Guideline and Systematic Review

The focus of the 2018 Chronic Kidney Disease (CKD) Guideline is on the treatment of adults with kidney disease. Nutrition and management is an integral part of the care of patients with kidney disease. Due to the most recent advances, the Academy of Nutrition and Dietetics and the National Kidney Foundation collaborated to merge, update and expand the 2010 Evidence Analysis Library® (EAL®) CKD project and the Kidney Disease Outcomes Quality Initiative (KDOQI) Nutrition Guidelines.

The overall objective of this initiative is to provide medical nutrition therapy (MNT) guidelines for patients with kidney disease to assess, prevent and treat protein-energy wasting, mineral and electrolyte disorders, and other metabolic disorders that are associated with kidney disease. For the Systematic Review, which supports the guideline, the workgroup was divided into three groups and each group concentrated their efforts on the following subtopics:

  • Macronutrients
  • Micronutrients
  • Electrolytes
  • Assessment: Nutritional Status, Dietary Intake, Energy Requirements
  • Medical Nutrition Therapy
  • Dietary Patterns

Systematic Review Key Findings: The systematic review found that nutritional intervention and counseling provided by RDNs had a beneficial effects in adults with CKD 1-5D, non-dialysis and transplant. Some of the major findings were: Protein restriction (low protein diets) had beneficial effects on ESRD/death; the effect of protein type on most of the outcomes was not clear; 7-point SGA scale was a reliable and valid tool to assess nutritional status; maintaining 

Meta-Analysis: The number of included studies, as well as the nature of the data, allowed the workgroup to further conduct meta-analysis for a number of subtopics.

The 2018 guideline recommendations are based on the systematic review plus evidence from other sources. The recommendations are in final stage of development. Some of the main outcomes include: Nutritional biomarkers, Anthropometric markers; Visceral protein stores; Somatic protein stores; Composite nutrition scores; Mortality, and End-stage renal disease. Estimated publication is summer 2019.

Use the left navigation bar to view the CKD systematic review. Expand the section below titled Project Team and Disclosures for a listing of individuals who contributed to the development of the project. disclosures and project funding information.

Updated: 5/10/2019

  • Project Team and Disclosures (2010)

    The following individuals contributed their valuable time and expertise to this project:

    Expert Workgroup

    • Jessie Pavlinac, MS, RD, CSR, LD, Chair
    • Arianna Aoun, MS, RD, CSR, LD
    • Laura Byham-Gray, PhD, RD
    • Carolyn C. Cochran, MS, RD, LD, CDE
    • Barbara A. Hutson, RD, LD
    • Joni Pagenkemper, MS, MA, RD, LMNT, CDE

    Former Workgroup Members

    • Pamela S. Kent, MS, RD, CSR, LD
    • Jinette S. Lichter, RD, LMNT
    • Cathi J. Martin, RD, CSR, LDN

    Project Manager

    • Mei Chung, PhD, MPH

    Lead Evidence Analyst

    • Erica K. Gradwell, MS, RD

    Evidence Analysts

    • Carly D. Gustafson, MS, RD, CD, LDN
    • Haewook Han, PhD, RD, LDN
    • Jodi A. Kingley, MS, RD, CNSD
    • Francoise Knox Kazimierczuk, MS, RD
    • Linda Massey, PhD, RD
    • Christiane Meireles, PhD, RD, LD
    • Carmen Tatum, MS, RD, CSP
    • Elisa Trigalo, RD, MS
    • Lee S. Wallace, MS, RD, FADA
    • Madelyn L. Wheeler, MS, RD, FADA

    Guideline Reviewers

    • Karen Basinger, RD
    • Debbie Benner, MA, RD, CSR
    • Jerrilyn Burrowes, PhD, RD, CDN
    • Louise Clement, MS,RD, CSR, LD
    • Charles J.Foulks, MD,FACP,FACN
    • Kathy Schiro Harvey, MS, RD, CSR
    • Maria Karalis, MBA, RD, LDN
    • Pamela S.Kent, MS, RD, CSR, LD
    • Elizabeth Kern, MD, MS
    • Nadiya Lakhani, RD, LD
    • Maureen McCarthy, MPH, RD,CSR, LD
    • Sharon R. Schatz, MS, RD, CSR, CDE

    Academy Staff

    • Deborah Cummins, PhD
    • Kari Kren, MPH, RD
    • Joan Schwaba, MS, RD, LDN
    • Esther F. Myers, PhD, RD


    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.

    • None of the workgroup members listed above disclosed potential conflicts.


    Financial Contributors

    • Academy of Nutrition and Dietetics
  • Project Team and Disclosures (2018)

    The following individuals contributed their valuable time and expertise on this project:

    Workgroup Members
     

    • Talat Alp Ikizler, MD, Co-Chair
      Catherine McLaughlin-Hakim Chair in Vascular Biology; Professor Medicine Vanderbilt University, Nashville, TN, USA
    • Lilian Cuppari, PhD, Co-Chair
      Oswaldo Ramos Foundation-Hrim, Federal University of São Paulo, São Paulo, Brazil
    • Jerrilynn D. Burrowes, PhD, RD, CDN
      Professor, Department of Nutrition, Long Island University, Brookville, NY, USA
    • Laura D. Byham-Gray, PhD, RD, FNKF
      Professor and Vice Chair of Research, Rutgers University, Newark, NJ USA
    • Katrina Louise Campbell, PhD AdvAPD
      Associate Professor, Bond University, Robina, Queensland, Australia
    • Juan Jesus Carrero, Pharm, PhD Pharm, PhD, Med MBA
      Professor of Renal Epidemiology, Karolinska University Hospital, Stockholm Sweden
    • Winnie Chan, PhD, RDN
      Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
    • Denis Fouque, MD, PhD
      Professor of Nephrology, Université de Lyon, Lyon, France
    • Allon Nir Friedman, MD, FASN
      Associate Professor of Medicine, Indiana University School of Medicine, Indianapolis, IN  USA
    • Sana Ghaddar, PhD, RDN
      Renal Dietitian, Davita Healthcare Partners, Fremont, CA, USA
    • D. Jordi Goldstein, DSc, APN, NP-C, RD
      Nephrology Nurse Practitioner, Lucile Packard Children’s Hospital Stanford, Palo Alto, CA
    • George Alan Kaysen, MD, PhD
      Professor Emeritus Internal Medicine and Biochemistry and Molecular Medicine, University of California-Davis School of Medicine, Davis, CA, USA
    • Joel Kopple, MD
      University of California-Los Angeles Medical Center, Torrance, CA, USA
    • Daniel Teta, MD, PhD
      Professor, Lausanne University / Chief of Service, Hospital du Valais, Sion, Switzerland
    • Angela Yee-Moon Wang, MB BS, MD, PhD,, FRCP, FHKCP, FHKAM, FASN
      University of Hong Kong, Hong Kong
       

    Evidence Analyst

    • Megan Baumer PhD, RD
      Professor, Mount Mary University, Milwaukee, WI, USA
    • Alison G. M. Brown, PhD, RD
      Boston Food Policy Council Member, Boston, MA, USA
    • Margaret Chenault, MS
      Project Manager/Coordinator, Drexel University, Philadelphia, PA, USA
    • Alanna M. Clark, MPH
    • Public Health Nutritionist (WIC), Mecklenburg County, Carolinas Healthcare Systems, Charlotte, NC, USA
    • Lisa A. Davis, MS, RD
      Clinical Dietitian, University of Wisconsin Hospital & Clinics, Madison, WI, USA
    • Sharon Foley, PhD, RDN
      Assistant Professor, Rush University, Chicago, IL, USA
    • Anne O. Garceau, MS, RDN
      Nutritionist, USDA, Beltsville, MD, USA
    • Erica K. Gradwell, MS, RD
      Consultant, Arvada, CO, USA
    • Keli Hawthorne, MS, RDN
      Director of Clinical Research, University of Texas at Austin Dell Medical School, Austin, TX, USA
    • Yi-Hsuan Liu, MS
      Graduate Research Assistant, The Pennsylvania State University, State College, PA, USA
    • Courtney T. Luecking, MPH, MS, RDN
      Doctoral Candidate, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
    • Haiyan Maier, PhD, RD
      Florida State University, Tallahassee, FL, USA
    • Christiane Lumachi Meireles, PhD, RDN, LD
    • Clinical Assistant Professor, University of Texas Health, San Antonio, TX, USA
    • Melanie M. Mott, PhD, RD
      Clinical Writer, Ipswich, MA, USA
    • Keiy C. Murofushi, MS, RDN
      Executive Director, Food and Nutrition, Cedars-Sinai Medical Center, Los Angeles, CA, USA
    • Joan Pleuss, MS, RDN
      Retired, Milwaukee, WI, USA
    • Krisa Shawron, MS, RD, LDN
      Clinical Research Coordinator, Rush University Medical Center, Chicago, IL USA
    • Helen D. Solomon, MBA, RD
      Retired, Wildwood, MO, USA
    • Terrance Vance, PhD, MS, RDN
      Assistant Professor, Dept. of Nutrition, SUNY College of Plattsburgh, Plattsburgh, NY
    • Amy Yahiro, MS, RD, LDN
      Manager, Evidence-Based Medicine, North American Spine Society, Burr Ridge, IL, USA
    • Jinyu Xu, PhD, MPH, RD
      Research Scientist, Nationwide Children’s Hospital, Columbus, OH, USA
       

    Academy of Nutrition and DIetetics Evidence Analysis Center Staff

    • Deepa Handu, PhD, RDN, LDN, Project Manager and Methodologist
    • Mary R. Rozga, PhD, RDN, Lead Analyst
    • Alison Stieber, PhD, RDN
    • Feon Cheng, PhD, MPH, RDN, CHTS-CP
    • Lisa Moloney, MS, RDN
       

    National Kidney Foundation / KDOQI Staff

    • Kerry Willis, PhD
    • Laura Brereton, MSc
    • Jessica Joseph, MBA
    • Thomas Manley, RN, BSN, CRNA
       

    FInancial Contributors

    • Academy of Nutrition and Dietetics
    • National Kidney Foundation
       

    Disclosures of Potential Conflicts of Interest

    In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.

    • Byham-Gray: Received compensation for consultant work from Abbott Nutrition and Nestle Nutrition; received fundin for a grant from NIDDK; received compensation from Abbott Nutrition and Nestle Nutrition for speaking/presentations; received compensation from Springer Publications for the Academy of Nutrition and Dietetics to author a publication 
    • Campbell: Received compensation for consultant work from Nestle Health Sciences
    • Carrero: Received funding for research grants from AstraZeneca and Relypsa on clinical epidemiological analyses on hyperkalemia in healthcare; consultant for AstraZeneca for an observational project on hyperkalemia in healthcare; received compensation from the International Society of Renal Nutrition and Metabolism for development of education presentations.
    • Fouque: Received compensation for serving on board of Fresenius Kabi; consultant for Sanofi Kabi Medice Astellas; received compensation for expert testimony from Sanofi; received compensation by Sanofi; Fresenius Kabi, Vifor for speaking/presentations; received reimbursement for meeting/travel expenses from Sanofi, Fresenius Kabi, Astellas, BBraun, Medice.
    • Ghaddar: Received compensation from ISRNM for speaking engagements; 
    • Ikizler: Received compensation for consultant work f rom Fresenius Kabi, Int, Abbott Renal Care, International Society of Nephrology, Satellitehealth, American Board of Internal Medicine, Baxter Renal Care, DSI Inc., Merck; Nestle, Reata, Prometic, Relypsa, Axcella
    • Kaysen: Received grant funding from National Institute of Health Nutrition Special Study Active/Adipose; compensation for consultant work on NIDDK DSMB; 

     

    updated: 5/10/2019