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Intervention
What are the energy requirements in adult non-dialyzed patients with chronic kidney disease, diabetic nephropathy or kidney transplant?
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Conclusion
CKD Patients: Normal Body Weight
Data from five RCTs published between 2001 and 2007, of patients with normal body weight, suggest that a total energy intake of 23kcal to 35kcal per kg of body weight (when consuming protein-restricted diets ranging from 0.3g to 0.7g per kg of body weight per day) is adequate to maintain stable BMI in adult non-diabetic patients with CKD. Other uncontrolled trials and cross-sectional studies suggest similar findings.
CKD Patients: Overweight With Diabetes
Data from three RCTs published between 2002 and 2005 of overweight patients with chronic kidney disease (mean BMI, approximately 27), with type 1 or type 2 diabetes, suggests that a total energy intake of 1,780kcal to 1,823kcal (when consuming protein-restricted diets ranging from 0.68g to 0.86g per kg body weight per day) can decrease body weight without resulting signs of malnutrition.
Post-Kidney Transplant Patients
Data from one before-and-after trial publised in 2003 of obese (mean BMI, 35.5), hyperhomocysteinuric patients with a new kidney transplant (one year post-transplantation) suggests that a diet of less than 30kcal per kg per day can significantly reduce BMI (mean BMI, -8kg/m2, P<0.03), LDL-cholesterol (-38mg per dL, P<0.01) and TG (-102mg per dL, P<0.01) after one year.
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Grade: II
- 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.
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Conclusion