KHA-CARI Autosomal Dominant Polycystic Kidney Disease Guideline: Diet and Lifestyle Management

The following statements are modified from the KHA-CARI Early CKD guidelines on modification of life-style and nutrition interventions for management of early chronic kidney disease, 2 National Health and Medical Research Council. Australian Dietary Guidelines: Canberra. NHMRC 2013. Available from: www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55_australian_dietary_guidelines_130530.pdf. Google Scholar as there is no evidence specific to ADPKD that would alter these recommendations: (http://www.cari.org.au/CKD/CKD%20early/Modification_of_Llifestyle_Nutrition_ECKD.pdf). a.We recommend that patients with progressive autosomal dominant polycystic kidney disease (ADPKD), prior to advanced kidney disease (ie, chronic kidney disease [CKD] stages 1 to 3), follow the recommendations from the National Health and Medical Research Council (NHMRC) Australian Dietary Guidelines (adults), including to achieve and maintain a healthy weight, be physically active, and choose a wide variety of nutritious foods 1 Chan M, Johnson D. Modification of lifestyle and nutrition interventions for management of early chronic kidney disease. 2013. Available from: www.cari.org.au/CKD/CKD%20early/Modification_of_Llifestyle_Nutrition_ECKD.pdf. Google Scholar (1D). b.We recommend a moderate protein diet (0.75-1.0 g/kg/day) as a low protein diet (≤0.6 g/kg/day) has not been shown to slow the rate of ADPKD progression and may increase the risk of malnutrition (1C). c.We recommend that patients with ADPKD restrict their dietary sodium intake to 100 mmol/day (or 2.3 g sodium or 6 g salt per day) or less, as it reduces blood pressure and albuminuria in patients with CKD (1C). d.We suggest that patients with ADPKD drink fluid to satisfy thirst, as there is no evidence that increasing fluid intake beyond thirst is beneficial for reducing cyst growth in ADPKD (2C). e.We recommend that patients with ADPKD stop, or do not start active smoking (and avoid passive smoking) to reduce CKD progression and cardiovascular risk (1C). f.We recommend that patients at high risk of ADPKD be provided with adequate genetic counseling and education regarding inheritance and future complications (refer to Genetics and Genetic Counseling section for further information) (1D). g.We recommend that patients at high risk of ADPKD be educated regarding risk factors for disease progression, specifically hypertension (1D). h.We suggest that all patients with ADPKD be taught self-management skills for blood pressure monitoring and low salt intake (2D). i.We suggest that all patients with ADPKD undergo psychosocial counseling and support (2D). Introduction to the KHA-CARI Guidelines on ADPKDSeminars in NephrologyVol. 35Issue 6PreviewKidney Health Australia–Caring for Australasians with Renal Impairment (KHA-CARI) Guidelines is an organization whose aim is to improve the health care and outcomes of adult and children with kidney disease through the development and implementation of evidence-based clinical practice guidelines ( www.cari.org.au ). Since 1999, KHA-CARI has overseen 28 guidelines (involving more than 100 guideline writers), covering topics in chronic kidney disease and dialysis and transplantation. Within this framework, KHA-CARI first developed a brief clinical practice guideline on autosomal dominant polycystic kidney disease (ADPKD) in 2007. Full-Text PDF