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Nutritional Recommendations for Chronic Kidney Disease: Principal Mechanisms and New Approaches

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition Methodology & Assessment".

Deadline for manuscript submissions: 25 November 2025 | Viewed by 1962

Special Issue Editors


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Guest Editor
Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
Interests: clinical nephrology; chronic kidney disease; glomerulonephritis; diabetic kidney disease; hypertension; thrombotic microangiopathies; renal tubular acidosis; acute kidney injury; dialysis; vitamin D; vascular access
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Co-Guest Editor
Unit of Geriatric Medicine, Italian National Research Center on Aging (IRCCS INRCA), 87100 Cosenza, Italy
Interests: pharmacoepidemiology; biostatistics; geriatric syndromes; multimorbidity; frailty; chronic kidney disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The prevalence of chronic kidney disease (CKD) is rising on a global scale. Patients with CKD lose the ability to excrete solutes and maintain homeostasis because of the particular role the kidney plays in the metabolism of nutrients. It is critical to adjust dietary intake and monitor nutritional status in this population as this can have a significant impact on important health outcomes such as the development of renal failure, quality of life, morbidity and death. The updated guidelines from The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) suggest a focused attention on nutritional assessment and medical nutrition therapy as well as monitoring the dietary protein, energy intake, nutritional supplementation, micronutrients and electrolytes of CKD patients.

In fact, these patients may exhibit dysregulation in fluid electrolyte and pH balance, blood pressure control, micronutrients, waste and toxin elimination, vitamin D metabolism and hormone regulation. This can lead to a major risk of oedema, hyperkalemia, hyperphosphatemia, chronic metabolic acidosis, bone loss and high blood pressure. Patients with CKD may experience fewer symptoms and a slower progression of the condition if their protein, phosphorus, potassium, sodium and calcium levels are monitored.

The relevance of diet in preventing kidney disease and its advancement is still strongly supported by the available data, and medical nutrition therapy with a certified dietitian and a multidisciplinary approach are key components of treatment for CKD.

The aim of this Special Issue is to contribute to the development of the body of knowledge on the principal mechanisms of and new approaches to nutritional strategies for CKD.

Dr. Guido Gembillo
Dr. Luca Soraci
Guest Editors

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Keywords

  • chronic kidney disease
  • Mediterranean diet
  • vitamin D
  • parathormone
  • hyperphosphatemia
  • diabetic kidney disease
  • hyperkalemia
  • metabolic acidosis
  • hemodialysis
  • hypertension

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Published Papers (1 paper)

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Research

19 pages, 1259 KB  
Article
Planetary Health Diet and Body Mass Distribution in Relation to Kidney Health: Evidence from NHANES 2003–2018
by Guido Gembillo, Luca Soraci, Maria Elsa Gambuzza, Maria Princiotto, Antonino Catalano, Edlin Villalta, Salvatore Silipigni, Giada Ida Greco, Andrea Corsonello and Domenico Santoro
Nutrients 2025, 17(16), 2692; https://doi.org/10.3390/nu17162692 - 20 Aug 2025
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Abstract
Background/Objectives: Chronic kidney disease (CKD) and diabetic kidney disease (DKD) are growing public health challenges. While diet and body composition influence metabolic and renal health, their combined role remains underexplored. This study investigates the association between the Planetary Health Diet Index (PHDI), body [...] Read more.
Background/Objectives: Chronic kidney disease (CKD) and diabetic kidney disease (DKD) are growing public health challenges. While diet and body composition influence metabolic and renal health, their combined role remains underexplored. This study investigates the association between the Planetary Health Diet Index (PHDI), body mass distribution, and the prevalence of CKD and DKD in U.S. adults. Methods: We analyzed data from 8093 adults aged ≥40 years from NHANES 2003–2018. PHDI was computed using two 24 h dietary recalls. Body composition was assessed using dual-energy X-ray absorptiometry (DXA), focusing on the android-to-gynoid fat ratio (AGFR) and lean mass ratio (AGLR). Survey-weighted linear and logistic regressions evaluated cross-sectional associations between PHDI score, body composition indices, and prevalence of CKD and DKD. Mediation analyses explored AGLR, AGFR, and body mass index (BMI) as potential mediators of the association between PHDI score and either CKD or DKD. Results: Higher PHDI scores were mildly associated with lower odds of CKD (OR per 10-point increase: 0.91; 95% CI: 0.83–0.99) and DKD (OR: 0.86; 95% CI: 0.76–0.97). Greater PHDI scores correlated with lower BMI, AGFR, and AGLR. Among participants with diabetes, AGLR mediated 17% of the relationship between a 10-point increase in PHDI score and decreased DKD prevalence, suggesting central lean mass distribution as a relevant pathway. No significant mediation was observed for AGFR, BMI, or for CKD. Conclusions: Adherence to PHD is associated with healthier body composition and lower prevalence of CKD and DKD. These findings support the promotion of dietary strategies that enhance metabolic and renal health in middle-aged and older individuals. Full article
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