Will nutritional interventions improve the prognosis of CKD
Can nutritional interventions result in better outcomes in patients with CKD?
PEW is the strongest predictor of increased mortality in patients with CKD of all stages.
Based on the compelling results of epidemiologic studies, it is plausible to postulate that interventions aimed at improving nutritional status could be beneficial in these patients. Unfortunately, there are no clinical trial data to prove this hypothesis, and because of this, nutritional interventions cannot be advocated as a means to improve patient survival.
Clinical trials have shown that various interventions can be successfully applied to improve biochemical measures of PEW (such as serum albumin) or to favorably change body composition, but it remains unclear if the application of such interventions (which include dietary and pharmacologic interventions) can result in better clinical outcomes.
Well-conducted large observational studies have suggested that nutritional supplementation in dialysis patients is associated with favorable outcomes.
The clinical benefit of such interventions would have to be proven in dedicated randomized controlled clinical trials.
