The value of personalized dietary-nutritional therapy in the management of chronic kidney disease

Low-protein diet (LPD) and supplemented very LPD (sVLPD), characterized by low sodium and phosphorus intake and a normo- to mildly hypercaloric energy intake, play a synergistic and additive role when combined with pharmacological treatment. However, the lack of a dedicated multidisciplinary team limits their effective implementation in the clinical practice. Such an approach could reduce healthcare costs by preserving kidney function through improved therapeutic adherence. LPDs differ in their proportion of plant-based proteins and in the possible supplementation with essential amino acids and ketoanalogues, which is mandatory with the sVLPD. Closenephro-nutritional monitoring is essential to tailor nutritional requirements to the individual needs of patients with CKD, as their estimation still relies largely on empirical algorithms. In addition, adapted exercise programs integrated with the dietary-nutritional therapy may contribute to improving patients’ health-related quality of life. Therefore, a consolidated multidisciplinary team should also include specialists in sports medicine and exercise professionals (kinesiologists).