Dietary therapy also may delay thrice-weekly dialysis and permit incremental or infrequent dialysis for patients with residual renal function, the authors suggested. Well-designed LPD and SVLPD possibly reduce the production and accumulation of toxic solutes in kidney failure.
“These findings strongly suggest that dietary therapy can be used to safely delay (for up to several months) the need for chronic dialysis in selected patients with pre-ESRD,” the authors wrote. “LPDs or SVLPDs may also provide patients with advanced CKD with sufficient time for placement and maturation of a permanent hemodialysis vascular access or peritoneal dialysis catheter without requiring the use of temporary catheters needed to inaugurate dialysis urgently.”
Finally, an obvious but important goal of kidney-friendly diets is preventing malnutrition. Renal diets need to be crafted to avoid protein-energy wasting. Patients also need adequate energy intake, along with sufficient calcium, trace elements (e.g., iron, zinc, selenium), and vitamins, particularly vitamin B6, folate, vitamin C, cholecalciferol, and 1,25-dihydroxycholecalciferol.
The authors encouraged more research, including randomized clinical trials, to answer outstanding questions on designing and implementing optimal renal diets.