THE ROLE OF NUTRITIONAL INTERVENTIONS AND SUPPLEMENTATION IN CHRONIC KIDNEY DISEASE – A NARRATIVE REVIEW

Résumé fourni par la source

Background: Chronic kidney disease (CKD) affects approximately 10% of the population and is associated with increased cardiovascular risk and mortality. In advanced stages, protein-energy wasting (PEW) and malnutrition-inflammation complex syndrome (MICS) are common and worsen clinical outcomes. Evidence suggests that nutritional interventions, including modification of protein, sodium, potassium, and phosphorus intake, and selected supplementation, may slow CKD progression and reduce metabolic complications. Aim: This review summarizes current evidence on nutritional interventions and supplementation in CKD, considering disease stage and treatment modality, and identifies gaps requiring further research. Materials and methods: A narrative review of international guidelines (KDIGO, KDOQI, ESPEN) and clinical trials and meta-analyses published between 2009-2026, identified through searches of PubMed, Cochrane Library, Scopus, and Google Scholar, focusing on CKD stages G3-G5. Results: Individualized protein restriction, sodium limitation, and qualitative phosphorus control improve metabolic parameters, blood pressure and albuminuria. Low- and very low-protein diets, particularly with amino acid ketoanalogue supplementation, are associated with slower CKD progression and a delayed initiation of renal replacement therapy. Plant-based diets may additionally improve acid-base balance, phosphate metabolism, and inflammation. The strongest evidence for supplementation concerns vitamin D, iron, and amino acid ketoanalogues, while data on omega-3 fatty acids, probiotics, and B vitamins remain inconclusive. Conclusions: Nutritional management is a key component of CKD care. Individualized dietary strategies and targeted supplementation may provide nephroprotective and metabolic benefits, although further high-quality randomized trials are needed to confirm effects on hard clinical endpoints.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.