Module 1: Understanding Chronic Kidney Disease (ckd)

Nutrition care may be an important component of prevention and treatment

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• Healthy eating patterns and physical activity may reduce chronic disease risk.
• Lifestyle interventions to prevent diabetes or hypertension may prevent or delay CKD onset.
• Lifestyle modifications are part of initial treatment interventions for prediabetes, diabetes, hypertension and cardiovascular disease.
• Once CKD is identified, dietary interventions are a key part of management.

Nutrition care is impacted and complicated by CKD

• Risk for hypoglycemia may increase.
• Blood pressure may be harder to control.
• Reduced urinary excretion of waste products may lead to hyperkalemia and metabolic acidosis.
• Anemia may develop.
• Abnormalities in vitamin D, phosphorus and calcium may impact bone strength and lead to vascular and soft tissue calcification.
• Nutrition care recommendations change when the kidneys fail based on the chosen renal replacement therapy (RRT).

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Healthy People 2020 includes CKD objectives that RDNs may impact

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Increase proportion of persons with CKD	Baseline	Target
CKD 2: who know they have impaired renal function	9.4	13.4%
CKD 4.1: who receive recommended medical evaluation with serum creatinine, lipids, and microalbuminuria	25.7%	28.3%
CKD 4.2: with type 1 or type 2 DM and CKD who receive recommended medical evaluation with serum creatinine, microalbuminuria, HbA1c, lipids, and eye exams	23.0%	25.3%
CKD 6.2: over age 50 who currently take statins to lower their cholesterol	21.6%	25.6%
Reduce proportion of persons with CKD
CKD 6.1: who have uncontrolled blood pressure	22.7%	17.6%

• https://www.healthypeople.gov/2020/topics-objectives/topic/chronic-kidney-disease/objectives