Diet In CKD ( Non Dialysis patients)

Diet in ckd in non dialysis patients:

1. We suggest the following dietary guidelines for most patients with egfr 60 ml/min/1.73 who are not on dialysis:
2. A daily protein intake of 0.8 g/kg. We do not recommend very-low-protein intake (0.6 g/kg/day).
3. A diet rich in vegetables.

The sodium intake varies depending on individual patient clinical features. Among individuals who are hypertensive, volume overloaded, or proteinuric, we suggest a sodium intake of 2 g/day (ie, 5 g/day of salt [nacl]).
For patients who are not hypertensive, volume overloaded, or proteinuric, sodium restriction to 2.3 g/day (5.75 g/day of salt [nacl]) may be of benefit. There are no convincing studies of the general population that have proven that lowering sodium intake to less than 2.3 g per day lowers cardiovascular outcomes or all-cause mortality. The institute of medicine has concluded that there is insufficient evidence to recommend a different sodium intake for ckd patients as compared with the general us population [2].

1. The potassium intake should be guided by serum potassium levels. If the potassium concentration is normal, we do not restrict dietary potassium. If the potassium concentration is high, dietary potassium intake should be restricted. 
2. Some clinicians target a total calcium intake (both dietary and medication sources) ≤1500 mg/day, whereas others prefer a more stringent goal of ≤1000 mg/day.
3. Maximum phosphorus intake of 0.8 to 1 g/day, even if the serum phosphorus concentration is normal; this is because some studies suggest that dietary phosphorus intake may alter circulating fibroblast growth factor (fgf)-23 concentration. The dietary phosphorus should be derived from sources of high biologic value, such as meats and eggs.
4. Maximum caloric intake of 30 to 35 kcal/kg/day.
5. Maximum fat intake - 30 percent of daily energy intake, with saturated fat limited to 10 percent energy.
6. Daily dietary fiber intake for 25 to 38 g/day.