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3. The PIRP project (Prevenzione Insufficienza Renale Progressiva): how to integrate hospital and community maintenance treatment for chronic kidney disease

Author

Santoro, Antonio, primary, Gibertoni, Dino, additional, Rucci, Paola, additional, Mancini, Elena, additional, Bonucchi, Decenzio, additional, Buscaroli, Andrea, additional, Campagna, Anselmo, additional, Cappelli, Gianni, additional, David, Salvatore, additional, Gregorini, Maria Cristina, additional, La Manna, Gaetano, additional, Mosconi, Giovanni, additional, Rigotti, Angelo, additional, Scarpioni, Roberto, additional, Storari, Alda, additional, and Mandreoli, Marcora, additional

Published
2019
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4. Nutritional treatment of advanced CKD: twenty consensus statements

Author

Cupisti, Adamasco, primary, Brunori, Giuliano, additional, Di Iorio, Biagio Raffaele, additional, D’Alessandro, Claudia, additional, Pasticci, Franca, additional, Cosola, Carmela, additional, Bellizzi, Vincenzo, additional, Bolasco, Piergiorgio, additional, Capitanini, Alessandro, additional, Fantuzzi, Anna Laura, additional, Gennari, Annalisa, additional, Piccoli, Giorgina Barbara, additional, Quintaliani, Giuseppe, additional, Salomone, Mario, additional, Sandrini, Massimo, additional, Santoro, Domenico, additional, Babini, Patrizia, additional, Fiaccadori, Enrico, additional, Gambaro, Giovanni, additional, Garibotto, Giacomo, additional, Gregorini, Mariacristina, additional, Mandreoli, Marcora, additional, Minutolo, Roberto, additional, Cancarini, Giovanni, additional, Conte, Giuseppe, additional, Locatelli, Francesco, additional, and Gesualdo, Loreto, additional

Published
2018
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8. Low-protein diets for chronic kidney disease patients: the Italian experience

Author

L. Oldrizzi, Piergiorgio Bolasco, Giuliano Brunori, Luca De Nicola, Lucia Di Micco, Adamasco Cupisti, Serena Torraca, Battista Fabio Viola, Roberto Minutolo, Vincenzo Bellizzi, Francesco Locatelli, Domenico Santoro, Biagio Di Iorio, Marcora Mandreoli, Stefania Caria, Giacomo Garibotto, Enrico Fiaccadori, Giorgina Barbara Piccoli, Giuseppe Quintaliani, Giovanni Cancarini, Bellizzi, Vincenzo, Cupisti, Adamasco, Locatelli, Francesco, Bolasco, Piergiorgio, Brunori, Giuliano, Cancarini, Giovanni, Caria, Stefania, DE NICOLA, Luca, Di Iorio, Biagio R, Di Micco, Lucia, Fiaccadori, Enrico, Garibotto, Giacomo, Mandreoli, Marcora, Minutolo, Roberto, Oldrizzi, Lamberto, Piccoli, Giorgina B, Quintaliani, Giuseppe, Santoro, Domenico, Torraca, Serena, and Viola, Battista F.

Subjects
Nephrology, medicine.medical_specialty, Nephrotic Syndrome, Low protein, medicine.medical_treatment, 030232 urology & nephrology, Psychological intervention, 030204 cardiovascular system & hematology, urologic and male genital diseases, Diabetes Complications, 03 medical and health sciences, 0302 clinical medicine, Chronic kidney disease, Internal medicine, Correspondence, Diet, Protein-Restricted, medicine, Humans, Nephrology, Low protein diet, Chronic kidney disease, amino acids, Medical nutrition therapy, Amino Acids, Renal Insufficiency, Chronic, Intensive care medicine, Dialysis, business.industry, Sodium, Dietary, medicine.disease, Adaptation, Physiological, Low protein diet, Malnutrition, Nutrition Assessment, Italy, Phosphorus, Dietary, Dietary Proteins, Energy Metabolism, business, Nephrotic syndrome, Kidney disease
Abstract

Background Nutritional treatment has always represented a major feature of CKD management. Over the decades, the use of nutritional treatment in CKD patients has been marked by several goals. The first of these include the attainment of metabolic and fluid control together with the prevention and correction of signs, symptoms and complications of advanced CKD. The aim of this first stage is the prevention of malnutrition and a delay in the commencement of dialysis. Subsequently, nutritional manipulations have also been applied in association with other therapeutic interventions in an attempt to control several cardiovascular risk factors associated with CKD and to improve the patient's overall outcome. Over time and in reference to multiple aims, the modalities of nutritional treatment have been focused not only on protein intake but also on other nutrients. Discussion This paper describes the pathophysiological basis and rationale of nutritional treatment in CKD and also provides a report on extensive experience in the field of renal diets in Italy, with special attention given to approaches in clinical practice and management. Summary Italian nephrologists have a longstanding tradition in implementing low protein diets in the treatment of CKD patients, with the principle objective of alleviating uremic symptoms, improving nutritional status and also a possibility of slowing down the progression of CKD or delaying the start of dialysis. A renewed interest in this field is based on the aim of implementing a wider nutritional therapy other than only reducing the protein intake, paying careful attention to factors such as energy intake, the quality of proteins and phosphate and sodium intakes, making today’s low-protein diet program much more ambitious than previous. The motivation was the reduction in progression of renal insufficiency through reduction of proteinuria, a better control of blood pressure values and also through correction of metabolic acidosis. One major goal of the flexible and innovative Italian approach to the low-protein diet in CKD patients is the improvement of patient adherence, a crucial factor in the successful implementation of a low-protein diet program.

Published
2016
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