Abstract

Nutrition optimization can be a beneficial intervention in slowing down the progression of chronic kidney disease (CKD). Oftentimes, especially in obese patients with CKD, nutritional interventions are complex; involve carbohydrate and lipid restrictive strategies in addition to limitations in protein intake of poor biological value. Given the long time course CKD can take in individuals and given the unpredictable nature of CKD which varies between individuals, it is essential that periodic long term follow up with any nutritional intervention in any patient be rigorously monitored to assess adherence to dietary regimen and avoid ill consequences of too strict of a strategy. Unfortunately, long-term outcomes data of optimal dietary interventional strategies and intake of various nutrients for patients with CKD are lacking, especially for obese diabetic patients. Nevertheless, understanding the effects of adequate and inadequate nutrition in renal disease can help clinicians and patients work together to modify key risk factors that impact CKD progression. This chapter reviews the aberrancies and pathophysiological mechanisms that are associated with various microand macro-nutrient imbalances and how those imbalances can impact CKD and other comorbidities, especially in patients suffering from metabolic syndrome and obesity.