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Implementation strategies for using oral nutritional supplements (ONS) in patients with stages 4-5 chronic kidney disease (CKD) are lacking in the UK and current international recommendations 1 are not tailored to the dietetic-led nutrition services prominent in the UK. A recent meeting of the Renal Nutrition Group (RNG) of the British Dietetic Association (BDA) identified a need for clarity on the use of ONS in these patients and as a result a group of seven renal dietitians, together with a general practitioner, met to discuss and reach agreement on a simple step-by-step consensus algorithm to guide the appropriate use of ONS in patients with stages 4-5 CKD.

Jan Flint summarises research on phosphate binders over the last few decades and highlights how this has affected the patient population with chronic kidney disease mineral bone disorder. It is evident that further research needs to be conducted in order to improve long-term outcomes for patients

This year's Sanofi Renal Forum for health professionals treating chronic kidney disease mineral bone disorder was recently held in Madrid, Spain. In this short article, Royal Free London NHS Trust's clinical lead renal dietitian, Jan Flint, gives readers an overview of the forum's key sessions and take-home messages, and reports on recent research findings on phosphate binders.