CKD: Guideline Recommendations and Supporting Information (2020)
Guideline recommendations are the essense of evidence-based guidelines and provide a course of action for the practioiner based on the evidence. Below, you will find a list of the Chronic Kidney Disease (2020) Recommendations with the Nutrition Care Process category. Download the Summary of Changes Table for an overview of the recommendation revisions and updates from the CKD 2010 guideline.
The Academy categorizes Recommendations in terms of either Imperative or Conditional statements. Conditional statements clearly define a specific situation or specific sub-population with the larger guideline population. Imperative statements are broadly applicable to the target population without restraints on their application. Each recommendation receives a rating, using the scale Strong, Fair, Weak, Consensus, or Insufficient Evidence. The rating for the recommendation is primarily based on the strenght of the supporting evidence but also the balance between benefits or harms anticipated and the clinial practice implications when the statment is follows. Learn more
The Academy is transitioning to the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework for developing clinical recommendations. The CKD recommendations were developed using both formats and were assigned ratings in both systems. Learn more
Resources Available with Each Recommendation
In addition to the recommendation statement and strength rating, you will find on each recommendation page:
- A brief narrative summary of the evidence analyzed to reach the recommendation
- A statement of justification, or reason for the strength of the recommendation
- Detailed information on the evidence supporting the recommendations and background narrative (available in the Supporting Evidence section toward the bottom of each recommendation page)
- A reference list at the end of each recommendation page that includes all the sources used in the evidence analysis for the particular recommendation (each reference is hyperlinked to a summary of the article analyzed in the evidence analysis).
Click on the blue recommendation title to view the full recommendations.
| EAL-KDOQI: Assessment Recommendations | |
|---|---|
| CKD: Nutrition Screening and Assessment: Usual-Care Statements | |
| Screening & Referral | Routine Nutrition Screening |
| Screening & Referral | Nutrition Screening Tools |
| Assessment | Routine Nutrition Assessment |
| CKD: Nutrition Assessment: Other Anthropometric Assessment Methods | |
| Assessment | Skinfold Thickness |
| Assessment | Waist Circumference |
| Assessment | Conicity Index |
| Assessment | Creatinine Kinetics |
| CKD: Nutrition Assessment: Body Mass Index (BMI) as a Predictor of Mortality | |
| Assessment | Body Mass Index (BMI) as a Predictor of Mortality, Maintenance Hemodialysis (MHD) |
| Assessment | Body Mass Index (BMI) as a Predictor of Mortality, Peritoneal Dialysis (PD) |
| Assessment | Body Mass Index (BMI) as a Predictor of Mortality, Non-Dialyzed |
| Assessment | Body Mass Index (BMI) as a Predictor of Mortality, Post-Transplant |
| CKD: Nutrition Assessment: Body Weight and Body Composition Usual-Care Statements | |
| Assessment | Body Composition and Body Weight/Body Mass Index (BMI) |
| Assessment | Frequency of Body Weight/Body Mass Index (BMI) and Body Composition Assessment |
| Assessment | Assessment of Body Weight |
| Assessment | Body Mass Index (BMI) and Protein Energy Wasting (PEW) |
| CKD: Nutrition Assessment Body Composition with Bioelectrical Impedance (BIA) and Dual-Energy X-Ray Absorptiometry (DEXA) | |
| Assessment | Bioelectrical Impedance for Patients on Maintenance Hemodialysis (MHD) |
| Assessment | Bioelectrical Impedance for Patients, Non-Dialyzed and on Peritoneal Dialysis (PD) |
| Assessment | Dual-Energy X-Ray Absorptiometry (DEXA) for Body Composition Assessment |
| CKD: Nutrition Assessment with Laboratory Measurements | |
| Assessment | Single Biomarker Measurements |
| Assessment | Serum Albumin Levels |
| CKD: Nutrition Assessment: Handgrip Strength | |
| Assessment | Handgrip Strength |
| CKD: Nutrition Assessment: Energy Requirements | |
| Assessment | Assessment of Resting Energy Expenditure |
| Assessment | Resting Energy Expenditure Equations |
| CKD: Nutrition Assessment: Composite Nutritional Indices | |
| Assessment | 7-Point Subjective Global Assessment (SGA) |
| Assessment | Malnutrition Inflammation Score (MIS) |
| CKD: Nutrition Assessment: Dietary Intake | |
| Assessment | Considerations when Assessing Dietary Intake |
| Assessment | 3-Day Food Records to Assess Dietary Intake |
| Assessment | Alternative Methods of Assessing Dietary Intake in CKD 3-5 |
| Assessment | Alternative Methods of Assessing Dietary Intake in CKD 5D |
| EAL-KDOQI CKD: Medical Nutrition Therapy Recommendation | |
| CKD: Medical Nutrition Therapy | |
| Intervention | MNT to Improve Outcomes |
| Intervention | MNT Content |
| Monitoring & Evaluation | MNT Monitoring and Evaluation |
| EAL:KDOQI: Macronutrient Recommendations | |
|---|---|
| CKD: Macronutrients: Dietary Patterns | |
| Intervention | Dietary Patterns: Mediterranean Diet |
| Intervention | Dietary Patterns: Fruits and Vegetables |
| CKD: Macronutrients: LC n-3 PUFA Nutritional Supplements for Lipid Profile | |
| Intervention | LC n-3 PUFA Nutritional Supplements for Lipid Profile, Maintenance Hemodialysis |
| Intervention | LC n-3 PUFA Nutritional Supplements for Lipid Profile, Peritoneal Dialysis |
| Intervention | LC n-3 PUFA Nutritional Supplements for Lipid Profile, Non-dialyzed |
| CKD: Macronutrients: LC n-3 PUFA Nutritional Supplements and Hard Outcomes | |
| Intervention | LC n-3 PUFA Nutritional Supplements for Mortality and Cardiovascular Disease, Maintenance Hemodialysis and Post-Transplant |
| Intervention | LC n-3 PUFA Nutritional Supplements for Mortality and Cardiovascular Disease, Peritoneal Dialysis |
| CKD: Macronutrients: Protein Amount | |
| Intervention | Protein Restriction, Non-Dialysis, Non-Diabetic |
| Intervention | Dietary Protein Intake, Maintenance Hemodialysis, Non-Diabetic |
| Intervention | Dietary Protein Intake, Peritoneal Dialysis, Non-Diabetic |
| CKD: Macronutrients: Protein Type | |
| Intervention | Macronutrients: Protein Type |
| Intervention | Macronutrients: Protein Type, Post-Transplant |
| CKD: Macronutrients: LC n-3 PUFA Nutritional Supplements for AV Graft and Fistula Patency and Kidney Allograft Survival | |
| Intervention | LC n-3 PUFA Nutritional Supplements for AV Graft and Fistula Patency for Maintenance Hemodialysis |
| Intervention | LC n-3 PUFA Nutritional Supplements for Kidney Allograft Survival |
| CKD: Macronutrients: Oral, Enteral and Intradialytic Parenteral Nutrition Supplementation | |
| Intervention | Oral Protein-Energy Supplementation for CKD 3-5D |
| Intervention | Oral Protein-Energy Supplementation for Post-Transplant |
| Intervention | Enteral Nutrition Supplementation |
| Intervention | Total Parenteral Nutrition (TPN) and Intradialytic Parenteral Nutrition (IDPN) Protein-Energy Supplementation |
| CKD: Macronutrients: Dialysate | |
| Intervention | Dialysate Protein-Energy Supplementation |
| CKD: Macronutrients: Protein Amount, Diabetes Mellitus | |
| Intervention | Protein Restriction, Non-Dialysis, Diabetic |
| Intervention | Dietary Protein Intake, Maintenance Hemodialysis and Peritoneal Dialysis, Diabetic |
| CKD: Macronutrients: Energy Intake | |
| Intervention | Statement on Energy Intake in CKD 1-5D |
| Intervention | Statement on Energy Intake in Post-Transplant |
| EAL-KDOQI CKD: Micronutrient Recommendations | |
| CKD: Micronutrients: General Guidance | |
| Intervention | Dietary Micronutrient Intake |
| Intervention | Micronutrient Assessment and Supplementation |
| Intervention | Micronutrient Supplementation, Dialysis |
| CKD: Micronutrients: Folic Acid and Vitamin B12 Supplementation | |
| Intervention | Folic Acid Supplementation for Hyperhomocysteinemia |
| Intervention | Folic Acid Supplementation for Folic Acid Deficiency and Insufficiency, CKD 1-5 and Dialysis |
| Intervention | Folic Acid Supplementation for Folic Acid Deficiency and Insufficiency, CKD Post-Transplant |
| CKD: Micronutrients: Vitamin C Supplementation | |
| Intervention | Vitamin C Supplementation |
| CKD: Micronutrients: Vitamin D Supplementation | |
| Intervention | Vitamin D Supplementation for Vitamin D Deficiency and Insufficiency, CKD 1-5D |
| Intervention | Vitamin D with Proteinuria |
| Intervention | Vitamin D Supplementation for Vitamin D Deficiency and Insufficiency, CKD Post-Transplant |
| CKD: Micronutrients: Vitamin E and A Supplementation | |
| Intervention | Vitamins E and A Supplementation and Toxicity |
| CKD: Micronutrients: Vitamin K Supplementation | |
| Intervention | Anticoagulant Medication and Vitamin K Supplementation |
| CKD: Micronutrients: Trace Mineral Supplementation, Selenium and Zinc | |
| Intervention | Selenium and Zinc Supplementation |
| EAL-KDOQI CKD: Electrolytes & Other Nutrients Recommendations | |
| CKD: Electrolytes: Phosphorus | |
| Intervention | Dietary Phosphorus Amount |
| Intervention | Dietary Phosphorus Source |
| Intervention | Phosphorus Intake with Hypophosphatemia |
| CKD: Electrolytes: Sodium | |
| Interention | Sodium Intake and Blood Pressure, CKD 3-5, Non-Dialyzed |
| Intervention | Sodium Intake and Blood Pressure, CKD 5D and Post-Transplant |
| Intervention | Sodium Intake and Proteinuria |
| Intervention | Sodium Intake and Dry Body Weight |
| CKD: Electrolytes: Potassium | |
| Intervention | Dietary Potassium Amount |
| Intervention | Dietary and Supplemental Potassium Intake for Hyperkalemia or Hypokalemia, CKD Post-Transplant |
| Intervention | Dietary and Supplemental Potassium Intake for Hyperkalemia or Hypokalmia, CKD 3-5D |
| CKD: Electrolytes: Acid Load | |
| Intervention | Dietary Management of Net Acid Production (NEAP) |
| Intervention | Bicarbonate Supplementation |
| Intervention | Bicarbonate Maintenance |
| CKD: Electrolytes: Calcium | |
| Intervention | Total Calcium Intake, CKD 3-4 |
| Intervention | Total Calcium Intake, CKD 5D |
| Proceed to Benefits & Risks/Harms of Implementation | Return to CKD Home |