CKD: Guideline Recommendations and Supporting Information (2020)

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

 

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 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


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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

 

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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

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