The Influence of Dietary Interventions on Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD)

Chronic kidney disease is a health problem whose prevalence is increasing worldwide. The kidney plays an important role in the metabolism of minerals and bone health and therefore, even at the early stages of CKD, disturbances in bone metabolism are observed. In the course of CKD, various bone turno...

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Bibliographic Details
Published in:Nutrients 2021-06, Vol.13 (6), p.2065
Main Authors: Rysz, Jacek, Franczyk, Beata, Rokicki, Robert, Gluba-Brzózka, Anna
Format: Article
Language:English
Subjects:
Biomedical materials
Bone density
Bone diseases
bone metabolism
Bone turnover
Calcification
Care and treatment
Chronic illnesses
chronic kidney disease
Chronic kidney failure
Dialysis
dietary interventions
Disturbances
Energy intake
Fibroblasts
Fractures
Fragility
Growth factors
Health risks
Hemodialysis
Hyperparathyroidism
Kidney diseases
Kidneys
Lipids
Metabolism
Mineralization
Mortality
Nitrogen balance
Osteomalacia
Pathogenesis
Phosphatase
Phosphorus
Physiological aspects
Prevention
Protein sources
Proteins
Renal failure
Renal insufficiency
Review
secondary hyperparathyroidism
Signal transduction
Signs and symptoms
Vitamin D
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Summary:Chronic kidney disease is a health problem whose prevalence is increasing worldwide. The kidney plays an important role in the metabolism of minerals and bone health and therefore, even at the early stages of CKD, disturbances in bone metabolism are observed. In the course of CKD, various bone turnover or mineralization disturbances can develop including adynamic hyperparathyroid, mixed renal bone disease, osteomalacia. The increased risk of fragility fractures is present at any age in these patients. Nutritional treatment of patients with advanced stages of CKD is aiming at prevention or correction of signs, symptoms of renal failure, avoidance of protein-energy wasting (PEW), delaying or prevention of the occurrence of mineral/bone disturbances, and delaying the start of dialysis. The results of studies suggest that progressive protein restriction is beneficial with the progression of renal insufficiency; however, other aspects of dietary management of CKD patients, including changes in sodium, phosphorus, and energy intake, as well as the source of protein and lipids (animal or plant origin) should also be considered carefully. Energy intake must cover patients’ energy requirement, in order to enable correct metabolic adaptation in the course of protein-restricted regimens and prevent negative nitrogen balance and protein-energy wasting.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu13062065