Academy of Nutrition and Dietetics Commentary on the Phosphorus Recommendation in the KDOQI Clinical Practice Guidelines for Nutrition in CKD: 2020 Update.

Autor:	Vergili JM; Registered Dietitian, Board Certified Specialist in Renal Nutrition, Research Consultant, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois., Proaño GV; Senior Research Project Manager, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois. Electronic address: gproano@eatright.org., Jimenez EY; Professor and Assistant Dean for Research, College of Population Health and Departments of Pediatrics and Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico., Moloney L; Nutrition Researcher, Level 2, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois., Papoutsakis C; Senior Director, Data Science Center, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois., Steiber A; Chief Science Officer, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois.
Jazyk:	angličtina
Zdroj:	Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation [J Ren Nutr] 2024 May; Vol. 34 (3), pp. 192-199. Date of Electronic Publication: 2023 Nov 23.
DOI:	10.1053/j.jrn.2023.11.001
Abstrakt:	The Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Nutrition in Chronic Kidney Disease: 2020 Update recommends adjusting dietary phosphorus to maintain a serum phosphate goal for hemodialysis patients in the normal range (0.81 to 1.45 mmol/L [2.5 to 4.5 mg/dL]). This is lower than the serum phosphate goal used by many dialysis centers (0.97 to 1.78 mmol/L [3.0 and 5.5 mg/dL]). Although context and clinical judgment must always be considered when providing individualized care to patients, a guideline implementation study conducted from December 2020 to December 2022 found that, based on their documentation, registered dietitian nutritionists from two national dialysis chains are almost universally using dialysis center goals instead of the lower phosphate goal recommended by the guideline. This commentary discusses the possible barriers to implementing the Kidney Disease Outcomes Quality Initiative 2020 nutrition guideline's phosphorus recommendation and proposes a systems level approach to promote and support adoption of the recommendation. Calls to action for potential changes in clinician practices, organizational/institutional culture, and government regulations are put forth. (Copyright © 2023 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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