Table 1.
Nutritional requirements for patients with non-dialysis CKD according to 2020 KDOQI Guidelines (18).
| ND-CKD stage 3–5 | Transplantation | |
|---|---|---|
| Energy (kcal/kg ideal weight/day)a | 25–35 | 25–35 in maintenance KTR 25 (obesity) 35–40 for the first 4 weeks after transplantation |
| Protein (g/kg/day)a,b | 0.55–0.60 or 0.28–0.43 plus keto/amino acid supplementation | 0.8 |
| 0.80–0.90 (diabetes) | 0.6–0.8 (CKD stages 3–5 T) | |
| 1.0 (illness) | ≥1.4 (for the first 4 weeks after transplantation or if high doses of prednisone is required) | |
| Sodium (g/day) | <2.3 | <2.3 |
| Potassiumc | Adjust dietary potassium intake to maintain serum potassium within the normal range | Adjust dietary potassium intake to maintain serum potassium within the normal range |
| Calcium (mg/day) | 800–1,000d | Insufficient data to define optimal dietary calcium intake in KTR (research priority) |
| Phosphoruse | Adjust dietary phosphorus intake to maintain serum phosphate levels in the normal range | Adjust dietary phosphorus intake to maintain serum phosphate levels in the normal range |
| Fiber (g/day) | 25–38 | 25–38 |
| Vitamin D (IU/day) | 600–800 | 600–800 |
| Vitamin B12 (μg/day)f | 2.4 | 2.4 |
| Folic acid (μg/day)f | 400 | 400 |
| Vitamin C (mg/day)f | 90 (M), 75 (W) | 90 (M), 75 (W) |
| Vitamin E (mg/day)f | 15 | 15 |
| Vitamin K (μg/day)f | 120 (M), 90 (W) | 120 (M), 90 (W) |
| Selenium (μg/day)f | 55 | 55 |
| Zinc (mg/day)f | 11 (M), 8 (W) | 11 (M), 8 (W) |
ND-CKD, non-dialysis chronic kidney disease; KTR, kidney transplant recipients; M, men; W, women.
Energy and protein intake should be adapted to age, gender, level of physical activity, body composition, weight status goals, CKD stage, and concurrent illness or presence of inflammation to maintain normal nutritional status. If present, priority should be given to the correction of protein-energy wasting.
Not enough evidence to make a statement on protein sources.
Guidelines do not suggest specific dietary K range (restriction per se may favor other nutrient deficiencies). Before restricting healthy foods, other causes of hyperkalemia (acidosis, constipation…) should be corrected.
Including dietary calcium, calcium supplementation, and calcium-based phosphate/potassium binders.
When making decisions about phosphorus restriction treatment, consider the bioavailability of phosphorus sources (e.g., animal, vegetable, additives).
No specific recommendations are provided by KDOQI guidelines. In the absence of evidence specific for persons with CKD, recommended Dietary Allowances for Adult General Population should apply.