Nutritional therapy in autosomal dominant polycystic kidney disease

J Nephrol. 2018 Oct;31(5):635-643. doi: 10.1007/s40620-018-0470-x. Epub 2018 Jan 17.

Abstract

CKD-related nutritional therapy (NT) is a crucial cornerstone of CKD patients' treatment, but the role of NT has not been clearly investigated in autosomal dominant polycystic kidney disease (ADPKD). Several clinical studies have focused on new pharmacological approaches to delay cystic disease progression, but there are no data on dietary interventions in ADPKD patients. The aim of this paper is to analyze the evidence from the literature on the impact of five nutritional aspects (water, sodium, phosphorus, protein intake, and net acid load) in CKD-related ADPKD extrapolating-where information is unavailable-from what occurs in CKD non-ADPKD patients Sodium intake restriction could be useful in decreasing the growth rate of cysts. Although further evidence is needed, restriction of phosphorus and protein intake restriction represent cornerstones of the dietary support of renal non-ADPKD patients and common sense can guide their use. It could be also helpful to limit animal protein, increasing fruit and vegetables intake together with a full correction of metabolic acidosis. Finally, fluid intake may be recommended in the early stages of the disease, although it is not to be prescribed in the presence of moderate to severe reduction of renal function.

Keywords: ADPKD; CKD; Fluid intake; Metabolic acidosis; Nutritional therapy; Phosphorus intake; Protein intake; Sodium intake.

Publication types

  • Review

MeSH terms

  • Acid-Base Equilibrium
  • Acidosis / diagnosis
  • Acidosis / diet therapy*
  • Acidosis / physiopathology
  • Diet, Healthy*
  • Dietary Proteins / administration & dosage
  • Drinking
  • Humans
  • Nutritional Status*
  • Nutritive Value*
  • Organism Hydration Status
  • Phosphorus, Dietary / administration & dosage
  • Polycystic Kidney, Autosomal Dominant / diagnosis
  • Polycystic Kidney, Autosomal Dominant / diet therapy*
  • Polycystic Kidney, Autosomal Dominant / physiopathology
  • Recommended Dietary Allowances
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / diet therapy*
  • Renal Insufficiency, Chronic / physiopathology
  • Sodium, Dietary / administration & dosage
  • Treatment Outcome

Substances

  • Dietary Proteins
  • Phosphorus, Dietary
  • Sodium, Dietary