Nutrition Intervention
CKD: Dietary Micronutrient Intake
In adults with CKD 3-5D or posttransplantation, it is reasonable for the registered dietitian nutritionist (RDN) or an international equivalent, to encourage eating a diet that meets the recommended dietary allowance (RDA) for adequate intake for all vitamins and minerals (OPINION)
CKD: Micronutrient Assessment and Supplementation
In adults with CKD 3-5D or posttransplantation, it is reasonable for the registered dietitian nutritionist (RDN) or an international equivalent, in close collaboration with a physician or physician assistant, to assess dietary vitamin intake periodically and to consider multivitamin supplementation for individuals with inadequate vitamin intake (OPINION).
CKD: Micronutrient Supplementation, Dialysis
In adults with CKD 5D who exhibit inadequate dietary intake for sustained periods of time, it is reasonable to consider supplementation with multivitamins, including all the water-soluble vitamins, and essential trace elements to prevent or treat micronutrient deficiencies (OPINION).
CKD: Folic Acid Supplementation for Hyperhomocysteinemia
In adults with CKD 3-5D or posttransplantation who have hyperhomocysteinemia associated with kidney disease, we recommend not to routinely supplementing folate with or without B-complex since there is no evidence demonstrating reduction in adverse cardiovascular outcomes (1A).
CKD: Folic Acid Supplementation for Folic Acid Deficiency and Insufficiency, CKD 1-5 and Dialysis
In adults with CKD 1-5D, we suggest prescribing folate, Vitamin B12 and/or B-complex supplement to correct for folate or Vitamin B12 deficiency/insufficiency, based on clinical signs and symptoms (B2).
CKD: Folic Acid Supplementation for Folic Acid Deficiency and Insufficiency, CKD Post-Transplant
In adults with CKD posttransplantation, we suggest prescribing folate, Vitamin B12 and/or B-complex supplement to correct for folate or Vitamin B12 deficiency/insufficiency based on clinical signs and symptoms (OPINION).
CKD: Vitamin C Supplementation
In adults with CKD 1-5D or posttransplantation who are at risk of Vitamin C deficiency it is reasonable to consider supplementation to meet the recommended intake of at least 90 mg/d for men and 75 mg/d for women (OPINION).
CKD: Vitamins E and A Supplementation and Toxicity
In adults with CKD 5D on MHD or CKD 5D on PD, it is reasonable to not routinely supplement Vitamin A or E because of the potential for vitamin toxicity. However, if supplementation is warranted, care should be taken to avoid excessive doses, and patients should be monitored for toxicity (OPINION).
CKD: Anticoagulant Medication and Vitamin K Supplementation
In adults with CKD 1-5D or posttransplantation, it is reasonable that patients receiving anticoagulant medicines known to inhibit vitamin K activity (e.g., warfarin compounds) do not receive vitamin K supplements (OPINION).
CKD: Selenium and Zinc Supplementation
In adults with CKD 1-5D, we suggest to not routinely supplementing selenium or zinc since there is little evidence that it improves nutritional, inflammatory or micronutrient status (2C).
CKD: Vitamin D Supplementation for Vitamin D Deficiency and Insufficiency, CKD 1-5D
In adults with CKD 1-5D (2C), we suggest prescribing Vitamin D supplementation in the form of cholecalciferol or ergocalciferol to correct 25(OH)D deficiency/insufficiency.
CKD: Vitamin D Supplementation for Vitamin D Deficiency and Insufficiency, CKD Post-Transplant
In adults with CKD posttransplantation, we suggest prescribing Vitamin D supplementation in the form of cholecalciferol or ergocalciferol to correct 25(OH)D deficiency/insufficiency (OPINION).
CKD: Vitamin D Supplementation with Proteinuria
In adults with CKD 1-5 with nephrotic-range proteinuria, it is reasonable to consider supplementation of cholecalciferol, ergocalciferol or other safe and effective 25(OH)D precursors (OPINION).
