Clinical Nutrition

There is scientific evidence that nutritional treatment can prevent or delay the progression of CKD, control symptoms and prevent or reduce the development of complications such as protein energy malnutrition (PEM) and cardiovascular disease (CVD). PEM is a common clinical finding in renal disease and has a negative bearing on quality of life, morbidity and mortality and therefore it should be adequately prevented, diagnosed and treated. Nutritional prescriptions in renal patients are complex because nutritional goals are multiple, and at time conflicting, yet the prescribed diets should be as realistic and practical as possible. Nutritional support is needed when spontaneous food intake is inadequate to cover nutrient requirements. The main topics of the chapter are: the physiopathology of acute and chronic renal failure, a review of the literature on the role of different nutrients on progression of kidney disease, diagnosis and classification of protein energy malnutrition, which is steel controversial, dietary treatment according to the most recent guidelines, nutritional practical tips, nutrition in dialysis and transplant patients.